Provider Demographics
NPI:1477001949
Name:EDWARDS, BRIANNE (MS/CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907A W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1303
Mailing Address - Country:US
Mailing Address - Phone:434-770-6188
Mailing Address - Fax:
Practice Address - Street 1:3907A W MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1303
Practice Address - Country:US
Practice Address - Phone:336-279-9008
Practice Address - Fax:336-740-9099
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11348235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist