Provider Demographics
NPI:1447793047
Name:BRIGGS, PRUDENCE ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:PRUDENCE
Middle Name:ELIZABETH
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195-02 69TH AVENUE
Mailing Address - Street 2:P.S. 026 RUFUS KING
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11365
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:195-02 69TH AVENUE
Practice Address - Street 2:P.S. 026 RUFUS KING
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11365
Practice Address - Country:US
Practice Address - Phone:718-464-4505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025903235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist