Provider Demographics
NPI:1205240306
Name:VINSON, BRITTANY NOELLE (SLP)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NOELLE
Last Name:VINSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:NOELLE
Other - Last Name:MCADAMS, MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:2281 ORCHID DR
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-6419
Mailing Address - Country:US
Mailing Address - Phone:520-234-0836
Mailing Address - Fax:
Practice Address - Street 1:200 E WILCOX DR
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2526
Practice Address - Country:US
Practice Address - Phone:520-459-8258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2019-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP10544235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist