Provider Demographics
NPI:1700261823
Name:LUONGO, BRITNI (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRITNI
Middle Name:
Last Name:LUONGO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:BRITNI
Other - Middle Name:
Other - Last Name:NOWAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:115 N 1ST AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-2867
Mailing Address - Country:US
Mailing Address - Phone:989-657-3078
Mailing Address - Fax:
Practice Address - Street 1:115 N 1ST AVE STE 101
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-2867
Practice Address - Country:US
Practice Address - Phone:989-657-3078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101007919235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist