Provider Demographics
NPI:1477237287
Name:PRICKETT, RYLEIGH BREANNA (AUD)
Entity Type:Individual
Prefix:
First Name:RYLEIGH
Middle Name:BREANNA
Last Name:PRICKETT
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 1:602 CORLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35957-5952
Mailing Address - Country:US
Mailing Address - Phone:256-571-8450
Mailing Address - Fax:
Practice Address - Street 1:602 CORLEY AVE
Practice Address - Street 2:
Practice Address - City:BOAZ
Practice Address - State:AL
Practice Address - Zip Code:35957-5952
Practice Address - Country:US
Practice Address - Phone:256-571-8450
Practice Address - Fax:256-840-4584
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1337A237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter