Provider Demographics
NPI:1255542544
Name:MANNSCHRECK, BRENDA S (MA CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:S
Last Name:MANNSCHRECK
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56715 714 RD
Mailing Address - Street 2:
Mailing Address - City:FAIRBURY
Mailing Address - State:NE
Mailing Address - Zip Code:68352-4038
Mailing Address - Country:US
Mailing Address - Phone:402-729-5956
Mailing Address - Fax:
Practice Address - Street 1:2200 H STREET
Practice Address - Street 2:FAIRBURY JEFFERSON COMMUNITY HEALTH CENTER
Practice Address - City:FAIRBURY
Practice Address - State:NE
Practice Address - Zip Code:68352-4038
Practice Address - Country:US
Practice Address - Phone:402-729-3351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE257235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist