Provider Demographics
NPI:1992009773
Name:DANIELS, BRITTNEY LARIN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:LARIN
Last Name:DANIELS
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 1:1112 N FLOYD RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4243
Mailing Address - Country:US
Mailing Address - Phone:972-470-5855
Mailing Address - Fax:972-470-5875
Practice Address - Street 1:1601 N COLLINS BLVD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3520
Practice Address - Country:US
Practice Address - Phone:972-470-5855
Practice Address - Fax:972-470-5875
Is Sole Proprietor?:No
Enumeration Date:2011-01-07
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103411235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217825301Medicaid