Provider Demographics
NPI:1659816049
Name:DACHER, BRYNN FAITH
Entity Type:Individual
Prefix:
First Name:BRYNN
Middle Name:FAITH
Last Name:DACHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58-74 57TH STREET
Mailing Address - Street 2:P9 WALTER REED SCHOOL
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378
Mailing Address - Country:US
Mailing Address - Phone:718-526-6210
Mailing Address - Fax:
Practice Address - Street 1:58-74 57TH STREET
Practice Address - Street 2:WALTER REED SCHOOL-P009Q
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378
Practice Address - Country:US
Practice Address - Phone:718-526-6210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008159-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist