Provider Demographics
NPI:1508432220
Name:ELDER, BRIANNA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:
Last Name:ELDER
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 1:1287 HAMILTON NEW LONDON RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-4009
Mailing Address - Country:US
Mailing Address - Phone:513-348-5436
Mailing Address - Fax:
Practice Address - Street 1:4641 BACH LN
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-1900
Practice Address - Country:US
Practice Address - Phone:513-829-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20211670-SP235Z00000X
OHSP.14911235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist