Provider Demographics
NPI:1770258873
Name:BURRIS, BRITTANY ELIZABETH (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ELIZABETH
Last Name:BURRIS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 N VERNAL AVE
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2104
Mailing Address - Country:US
Mailing Address - Phone:435-299-2399
Mailing Address - Fax:
Practice Address - Street 1:80 N VERNAL AVE
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-2104
Practice Address - Country:US
Practice Address - Phone:435-299-2399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN46003780A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist