Provider Demographics
NPI:1003103649
Name:ZEINERT, BRIANNA NOELLE (MS SLP)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:NOELLE
Last Name:ZEINERT
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 DELAWARE AVE APT H
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WI
Mailing Address - Zip Code:53024-9471
Mailing Address - Country:US
Mailing Address - Phone:608-213-8090
Mailing Address - Fax:
Practice Address - Street 1:W76N677 WAUWATOSA RD
Practice Address - Street 2:
Practice Address - City:CEDARBURG
Practice Address - State:WI
Practice Address - Zip Code:53012-1707
Practice Address - Country:US
Practice Address - Phone:608-377-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-04
Last Update Date:2011-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3560-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist