Provider Demographics
NPI:1942692934
Name:O'NEILL, BRIANA F (CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:BRIANA
Middle Name:F
Last Name:O'NEILL
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 1:247 WASHINGTON AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:MA
Mailing Address - Zip Code:02152-1343
Mailing Address - Country:US
Mailing Address - Phone:857-816-9078
Mailing Address - Fax:
Practice Address - Street 1:247 WASHINGTON AVE APT 9
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:MA
Practice Address - Zip Code:02152-1313
Practice Address - Country:US
Practice Address - Phone:857-816-9078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-27
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4809235Z00000X
MA9345235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist