Provider Demographics
NPI:1659646578
Name:TRICE, BRITTNEY BESSILLIEU (EDS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRITTNEY
Middle Name:BESSILLIEU
Last Name:TRICE
Suffix:
Gender:F
Credentials:EDS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6368 FOGGY OAK DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-4675
Mailing Address - Country:US
Mailing Address - Phone:770-851-4918
Mailing Address - Fax:
Practice Address - Street 1:6368 FOGGY OAK DR
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-4675
Practice Address - Country:US
Practice Address - Phone:770-851-4918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-09
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007559235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist