Provider Demographics
NPI:1336622307
Name:DEPAOLA, BRITTNEY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:DEPAOLA
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 1:478 RIDGEBURY RD
Mailing Address - Street 2:
Mailing Address - City:SLATE HILL
Mailing Address - State:NY
Mailing Address - Zip Code:10973-4300
Mailing Address - Country:US
Mailing Address - Phone:914-850-0180
Mailing Address - Fax:
Practice Address - Street 1:1657 E NOXON RD
Practice Address - Street 2:
Practice Address - City:LAGRANGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12540-4302
Practice Address - Country:US
Practice Address - Phone:845-223-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027078235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist