Provider Demographics
NPI:1104196567
Name:WALDRON, BRITTANY (MS CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:WALDRON
Suffix:
Gender:F
Credentials:MS CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 ALYS DR E
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-1420
Mailing Address - Country:US
Mailing Address - Phone:716-686-3285
Mailing Address - Fax:
Practice Address - Street 1:86 ALYS DR E
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-1420
Practice Address - Country:US
Practice Address - Phone:716-686-3285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist