Provider Demographics
NPI:1790936417
Name:PERKINS, BRANDI M (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:M
Last Name:PERKINS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-3045
Mailing Address - Country:US
Mailing Address - Phone:479-524-0564
Mailing Address - Fax:
Practice Address - Street 1:825 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-4147
Practice Address - Country:US
Practice Address - Phone:479-524-8130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1673235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist