Provider Demographics
NPI:1588045876
Name:BEAVER, BRITTANY LEIGH (MED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LEIGH
Last Name:BEAVER
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 MOLESWORTH DR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7635
Mailing Address - Country:US
Mailing Address - Phone:336-848-0927
Mailing Address - Fax:
Practice Address - Street 1:911 MOLESWORTH DR
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-7635
Practice Address - Country:US
Practice Address - Phone:336-848-0927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9926235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist