Provider Demographics
NPI:1144588393
Name:BOREL, BRYTNI NICOLE (AUD)
Entity Type:Individual
Prefix:
First Name:BRYTNI
Middle Name:NICOLE
Last Name:BOREL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:BRYTNI
Other - Middle Name:NICOLE
Other - Last Name:HUMPHREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1025 TEXAS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BRIDGE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77611-3675
Mailing Address - Country:US
Mailing Address - Phone:409-792-5035
Mailing Address - Fax:409-683-9037
Practice Address - Street 1:1025 TEXAS AVE STE B
Practice Address - Street 2:
Practice Address - City:BRIDGE CITY
Practice Address - State:TX
Practice Address - Zip Code:77611-3675
Practice Address - Country:US
Practice Address - Phone:409-792-5035
Practice Address - Fax:409-683-9037
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80387231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter