Brianne Roberts

Individual provider Active NPI Speech-Language Pathologist · Olyphant, PA

NPI 1306149745 · NPPES record last updated Dec 7, 2010

Key facts

NPI
1306149745
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SL008093 (PA)
Practice address
102 Wood St
Olyphant, PA 18447-2315
Phone
(570) 656-9714
NPI assigned
Dec 7, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SL008093PAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL008093 PA Yes

Addresses

Primary practice location

102 Wood St
Olyphant, PA 18447-2315

Mailing address

102 Wood St
Olyphant, PA 18447-2315

Other providers in Olyphant, PA

All providers in Olyphant, PA · Speech-Language Pathologist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.