Provider Demographics
NPI:1942518055
Name:GUYNUP, BRIANNE (MS-CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRIANNE
Middle Name:
Last Name:GUYNUP
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 1:1714 DUDLEY DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-2154
Mailing Address - Country:US
Mailing Address - Phone:833-575-2277
Mailing Address - Fax:
Practice Address - Street 1:1714 DUDLEY DR
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-2154
Practice Address - Country:US
Practice Address - Phone:833-575-2277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007854235Z00000X
NY017745235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist