Provider Demographics
NPI:1295043511
Name:FENOGLIO, BRIGID ANN (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRIGID
Middle Name:ANN
Last Name:FENOGLIO
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8713 BROWNE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-2819
Mailing Address - Country:US
Mailing Address - Phone:402-571-8185
Mailing Address - Fax:
Practice Address - Street 1:8713 BROWNE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-2819
Practice Address - Country:US
Practice Address - Phone:402-571-8185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE816235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist