Provider Demographics
NPI:1114655800
Name:MEHRINGER, BREANNA (MA CF-SLP)
Entity Type:Individual
Prefix:
First Name:BREANNA
Middle Name:
Last Name:MEHRINGER
Suffix:
Gender:F
Credentials:MA CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1847 MANCHESTER AVE NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44647-9623
Mailing Address - Country:US
Mailing Address - Phone:330-837-7800
Mailing Address - Fax:
Practice Address - Street 1:1847 MANCHESTER AVE NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647-9623
Practice Address - Country:US
Practice Address - Phone:330-837-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20222019-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist