Provider Demographics
NPI:1437791928
Name:STEVENS, BRITNEY ANNE TAYLOR (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRITNEY
Middle Name:ANNE TAYLOR
Last Name:STEVENS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 BROOKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:UT
Mailing Address - Zip Code:84075-9843
Mailing Address - Country:US
Mailing Address - Phone:801-800-3512
Mailing Address - Fax:
Practice Address - Street 1:915 N 400 W STE 110
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-2383
Practice Address - Country:US
Practice Address - Phone:801-217-3390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11228140-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist