Provider Demographics
NPI:1609209659
Name:O'BRIEN, BRANDE MARIE (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:BRANDE
Middle Name:MARIE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-2221
Mailing Address - Country:US
Mailing Address - Phone:719-491-3734
Mailing Address - Fax:
Practice Address - Street 1:1521 PRAIRIE RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-2221
Practice Address - Country:US
Practice Address - Phone:719-491-3734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0001421235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist