Provider Demographics
NPI:1942308887
Name:BRIGGS, CONSTANCE DEE (SLP)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:DEE
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:CONNIE
Other - Middle Name:
Other - Last Name:BRIGGS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP
Mailing Address - Street 1:800 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-5340
Mailing Address - Country:US
Mailing Address - Phone:304-420-5783
Mailing Address - Fax:304-420-5788
Practice Address - Street 1:800 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-5340
Practice Address - Country:US
Practice Address - Phone:304-420-5783
Practice Address - Fax:304-420-5788
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-0065235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0153204-000Medicaid