Provider Demographics
NPI:1467699033
Name:POULIOT, BRANDY (AUD)
Entity Type:Individual
Prefix:DR
First Name:BRANDY
Middle Name:
Last Name:POULIOT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 BUTTONWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-7112
Mailing Address - Country:US
Mailing Address - Phone:603-799-6434
Mailing Address - Fax:
Practice Address - Street 1:7593 W BOYNTON BEACH BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-6154
Practice Address - Country:US
Practice Address - Phone:561-742-9880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-19
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1528231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist