Provider Demographics
NPI:1346410180
Name:NICHOLS, BRIANA DORNAN (AUD CCC-A)
Entity Type:Individual
Prefix:DR
First Name:BRIANA
Middle Name:DORNAN
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:AUD CCC-A
Other - Prefix:DR
Other - First Name:BRIANA
Other - Middle Name:KELLY
Other - Last Name:DORNAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD CCCA
Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:LO-367
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:617-355-6417
Mailing Address - Fax:617-730-0611
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:LO-367
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-6417
Practice Address - Fax:617-730-0611
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA681231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist