Provider Demographics
NPI:1952075194
Name:MCELROY, BRYN NICOLE
Entity Type:Individual
Prefix:
First Name:BRYN
Middle Name:NICOLE
Last Name:MCELROY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-2807
Mailing Address - Country:US
Mailing Address - Phone:330-853-6376
Mailing Address - Fax:
Practice Address - Street 1:4275 OWENS RD
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3066
Practice Address - Country:US
Practice Address - Phone:706-868-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist