Provider Demographics
NPI:1427559111
Name:BREN-X AUDITORY SOLUTIONS LLC
Entity Type:Organization
Organization Name:BREN-X AUDITORY SOLUTIONS LLC
Other - Org Name:BREN- X AUDITORY SOLUTIONS LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:LETICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAYTOR-HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:AU D
Authorized Official - Phone:202-271-3936
Mailing Address - Street 1:2253 WELSH DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-6930
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2253 WELSH DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-6930
Practice Address - Country:US
Practice Address - Phone:202-271-3936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001417231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty