Provider Demographics
NPI:1083926281
Name:OLROYD, BRANDY
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:OLROYD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BENLD
Mailing Address - State:IL
Mailing Address - Zip Code:62009-1321
Mailing Address - Country:US
Mailing Address - Phone:217-851-2749
Mailing Address - Fax:
Practice Address - Street 1:507 N 5TH ST
Practice Address - Street 2:
Practice Address - City:BENLD
Practice Address - State:IL
Practice Address - Zip Code:62009-1321
Practice Address - Country:US
Practice Address - Phone:217-851-2749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146010563235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist