Provider Demographics
NPI:1235438649
Name:GRAY, BRITTNEY R (SLP)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:R
Last Name:GRAY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:BRITTNEY
Other - Middle Name:R
Other - Last Name:GEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 W LANE AVE
Mailing Address - Street 2:APT. 412
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43221-3956
Mailing Address - Country:US
Mailing Address - Phone:314-323-2620
Mailing Address - Fax:314-323-2620
Practice Address - Street 1:1600 W LANE AVE
Practice Address - Street 2:APT. 412
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43221-3956
Practice Address - Country:US
Practice Address - Phone:314-323-2620
Practice Address - Fax:314-323-2620
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP. 11201235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist