Provider Demographics
NPI:1699188136
Name:TERRY, BRIANNE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:TERRY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 W ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5901
Mailing Address - Country:US
Mailing Address - Phone:256-412-2432
Mailing Address - Fax:
Practice Address - Street 1:500 JOHN ALDRIDGE DR
Practice Address - Street 2:
Practice Address - City:TUSCUMBIA
Practice Address - State:AL
Practice Address - Zip Code:35674-3000
Practice Address - Country:US
Practice Address - Phone:256-383-4541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2761235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist