Provider Demographics
NPI:1639928021
Name:BRUMWELL, STEVIE LYNN
Entity type:Individual
Prefix:
First Name:STEVIE
Middle Name:LYNN
Last Name:BRUMWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2268 S OSBORN LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-0012
Mailing Address - Country:US
Mailing Address - Phone:661-992-6530
Mailing Address - Fax:
Practice Address - Street 1:1415 N SAN BENITO DR
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2490
Practice Address - Country:US
Practice Address - Phone:480-900-3051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP14688235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist