Provider Demographics
NPI:1346494291
Name:SCHWARTZ, BREANNE DAVIDSON (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BREANNE
Middle Name:DAVIDSON
Last Name:SCHWARTZ
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 1:9 AHWAGA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3701
Mailing Address - Country:US
Mailing Address - Phone:917-968-9063
Mailing Address - Fax:
Practice Address - Street 1:9 AHWAGA AVE
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3701
Practice Address - Country:US
Practice Address - Phone:413-570-3238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018330235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist