Provider Demographics
NPI:1326026055
Name:WESTON, BRIEN D (MS, CCC/A)
Entity Type:Individual
Prefix:
First Name:BRIEN
Middle Name:D
Last Name:WESTON
Suffix:
Gender:M
Credentials:MS, CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 41 BOX 1271
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09464
Mailing Address - Country:GB
Mailing Address - Phone:01144163-852-8575
Mailing Address - Fax:
Practice Address - Street 1:EAR, NOSE & THROAT/48MEDICAL GROUP/SGOSLA
Practice Address - Street 2:RAF LAKENHEATH
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09464
Practice Address - Country:GB
Practice Address - Phone:01144163-852-8575
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23001994A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist