Provider Demographics
NPI:1710557491
Name:THOMAS, BRIANNA LANDERS (AUD)
Entity Type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:LANDERS
Last Name:THOMAS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8075 MADISON BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2042
Mailing Address - Country:US
Mailing Address - Phone:256-489-0903
Mailing Address - Fax:
Practice Address - Street 1:8075 MADISON BLVD STE 108
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2042
Practice Address - Country:US
Practice Address - Phone:256-489-0903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-25
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2065231H00000X, 237600000X
AL1339A237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
14415347OtherASHA CERTIFICATION
AL1339AOtherALABAMA BOARD OF EXAMINERS FOR SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY
TN2065OtherTENNESSEE BOARD OF COMMUNICATION DISORDERS AND SCIENCES LICENSE