Provider Demographics
NPI:1659972776
Name:MITCHELL, BRIANNA NOEL TIPTON (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:NOEL TIPTON
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:NOEL TIPTON
Other - Last Name:YOVAN
Other - Suffix:II
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8485 SPRECKELS LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-6138
Mailing Address - Country:US
Mailing Address - Phone:909-744-4575
Mailing Address - Fax:
Practice Address - Street 1:11838 BERNARDO PLAZA CT STE 110
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2414
Practice Address - Country:US
Practice Address - Phone:185-867-3543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist