Provider Demographics
NPI:1477919488
Name:BROST, BRITLEE
Entity Type:Individual
Prefix:
First Name:BRITLEE
Middle Name:
Last Name:BROST
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 1:1309 W 102ND ST
Mailing Address - Street 2:FL 3
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-1650
Mailing Address - Country:US
Mailing Address - Phone:740-704-0791
Mailing Address - Fax:
Practice Address - Street 1:9200 BIDDULPH RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-2614
Practice Address - Country:US
Practice Address - Phone:216-485-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3243721235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist