Provider Demographics
NPI:1598956302
Name:BRITT, DEENA MATHIS (MED, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEENA
Middle Name:MATHIS
Last Name:BRITT
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 1:174 BROWN SMALL RD
Mailing Address - Street 2:
Mailing Address - City:LESLIE
Mailing Address - State:GA
Mailing Address - Zip Code:31764-2217
Mailing Address - Country:US
Mailing Address - Phone:229-853-3004
Mailing Address - Fax:
Practice Address - Street 1:174 BROWN SMALL RD
Practice Address - Street 2:
Practice Address - City:LESLIE
Practice Address - State:GA
Practice Address - Zip Code:31764-2217
Practice Address - Country:US
Practice Address - Phone:229-853-3004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP005019235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist