Provider Demographics
NPI:1285005686
Name:BRYNER, MAEGAN (SLP)
Entity Type:Individual
Prefix:
First Name:MAEGAN
Middle Name:
Last Name:BRYNER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 HARRISON AVENUE
Mailing Address - Street 2:MORGAN COUNTY BOARD OF EDUCATION
Mailing Address - City:BERKELEY SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:25411
Mailing Address - Country:US
Mailing Address - Phone:304-267-3595
Mailing Address - Fax:304-267-3599
Practice Address - Street 1:247 HARRISON AVENUE
Practice Address - Street 2:MORGAN COUNTY BOARD OF EDUCATION
Practice Address - City:BERKELEY SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:25411
Practice Address - Country:US
Practice Address - Phone:304-267-3595
Practice Address - Fax:304-267-3599
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-0796235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist