Provider Demographics
NPI:1518305481
Name:BRENNAN, TERRI E (SLP)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:E
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:582 SUTTON RD
Mailing Address - Street 2:
Mailing Address - City:SHAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18708-9802
Mailing Address - Country:US
Mailing Address - Phone:702-374-7229
Mailing Address - Fax:
Practice Address - Street 1:1440 CORAL RIDGE DR
Practice Address - Street 2:SUITE 435
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-5433
Practice Address - Country:US
Practice Address - Phone:800-568-4733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL011041235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist