Provider Demographics
NPI:1083054944
Name:BRANHAM, KIFFNEY DEE (MA/CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:KIFFNEY
Middle Name:DEE
Last Name:BRANHAM
Suffix:
Gender:F
Credentials:MA/CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 W MCCORMICK RD
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-8932
Mailing Address - Country:US
Mailing Address - Phone:407-886-0750
Mailing Address - Fax:
Practice Address - Street 1:1908 W MCCORMICK RD
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-8932
Practice Address - Country:US
Practice Address - Phone:407-886-0750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA11019235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist