Provider Demographics
NPI:1639932635
Name:DEPAULO, BRIANNA ROSE (CF-SLP)
Entity Type:Individual
Prefix:MISS
First Name:BRIANNA
Middle Name:ROSE
Last Name:DEPAULO
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-3304
Mailing Address - Country:US
Mailing Address - Phone:347-681-0721
Mailing Address - Fax:
Practice Address - Street 1:40 IRVING PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2305
Practice Address - Country:US
Practice Address - Phone:212-253-7076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist