Provider Demographics
NPI:1437364957
Name:BRANNEN, KRISTI JANE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:KRISTI
Middle Name:JANE
Last Name:BRANNEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-6031
Mailing Address - Country:US
Mailing Address - Phone:864-356-6358
Mailing Address - Fax:
Practice Address - Street 1:212 NORTH ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-6031
Practice Address - Country:US
Practice Address - Phone:864-356-6358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist