Provider Demographics
NPI:1336879147
Name:SLP BRENNA LLC
Entity Type:Organization
Organization Name:SLP BRENNA LLC
Other - Org Name:CONNECTABILITIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BRENNA
Authorized Official - Middle Name:G
Authorized Official - Last Name:ZACCARIA
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:504-487-2736
Mailing Address - Street 1:9079 W. JUDGE PEREZ DR.
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043
Mailing Address - Country:US
Mailing Address - Phone:504-487-2736
Mailing Address - Fax:
Practice Address - Street 1:9079 W. JUDGE PEREZ DR.
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043
Practice Address - Country:US
Practice Address - Phone:504-487-2736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty