Provider Demographics
NPI:1508023961
Name:PARRETT, BREANNA RAE (MED CF-SLP)
Entity Type:Individual
Prefix:MISS
First Name:BREANNA
Middle Name:RAE
Last Name:PARRETT
Suffix:
Gender:F
Credentials:MED CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2249 VINSON HWY SE
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-4807
Mailing Address - Country:US
Mailing Address - Phone:478-453-0163
Mailing Address - Fax:478-453-0164
Practice Address - Street 1:2249 VINSON HWY SE
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-4807
Practice Address - Country:US
Practice Address - Phone:478-453-0163
Practice Address - Fax:478-453-0164
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET001289235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist