Provider Demographics
NPI:1205550555
Name:DAY, BRITT JEPPSON (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:BRITT
Middle Name:JEPPSON
Last Name:DAY
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 1:5121 NW BOYKIN RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:FL
Mailing Address - Zip Code:32321-2427
Mailing Address - Country:US
Mailing Address - Phone:850-509-9607
Mailing Address - Fax:
Practice Address - Street 1:14757 NW COUNTY ROAD 12
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:FL
Practice Address - Zip Code:32321-3684
Practice Address - Country:US
Practice Address - Phone:850-643-2426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6882235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist