Provider Demographics
NPI:1356605570
Name:EVANS, BRIANA (SLP)
Entity type:Individual
Prefix:MS
First Name:BRIANA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2186 5TH AVE
Mailing Address - Street 2:APT 8B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-2704
Mailing Address - Country:US
Mailing Address - Phone:347-423-7631
Mailing Address - Fax:
Practice Address - Street 1:2186 5TH AVE
Practice Address - Street 2:APT 8B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-2704
Practice Address - Country:US
Practice Address - Phone:347-423-7631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020856235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist