Provider Demographics
NPI:1821246398
Name:LEWIS, BRITTANY MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:LEWIS
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 1:1088 E 680 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-4366
Mailing Address - Country:US
Mailing Address - Phone:801-787-2234
Mailing Address - Fax:
Practice Address - Street 1:1088 E 680 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-4366
Practice Address - Country:US
Practice Address - Phone:801-787-2234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7454702-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist