Provider Demographics
NPI:1669053021
Name:BRUA, SKYLAR ANN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SKYLAR
Middle Name:ANN
Last Name:BRUA
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 1:14500 E 42ND ST S STE 220
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-4700
Mailing Address - Country:US
Mailing Address - Phone:816-478-7800
Mailing Address - Fax:816-478-7839
Practice Address - Street 1:14500 E 42ND ST S STE 220
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-4700
Practice Address - Country:US
Practice Address - Phone:816-478-7800
Practice Address - Fax:816-478-7839
Is Sole Proprietor?:No
Enumeration Date:2021-04-17
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist