Provider Demographics
NPI:1558778795
Name:THOMASON, BRITTANY ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:ANN
Last Name:THOMASON
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 1:407 FARMER RD
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:MO
Mailing Address - Zip Code:65781-9509
Mailing Address - Country:US
Mailing Address - Phone:417-742-0930
Mailing Address - Fax:
Practice Address - Street 1:407 FARMER RD
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:MO
Practice Address - Zip Code:65781-9509
Practice Address - Country:US
Practice Address - Phone:417-742-0930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014020563235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist