Provider Demographics
NPI:1740929876
Name:BRYNAC, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:BRYNAC
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 1:3905 N GALVIN RD
Mailing Address - Street 2:
Mailing Address - City:SIBLEY
Mailing Address - State:MO
Mailing Address - Zip Code:64088-9552
Mailing Address - Country:US
Mailing Address - Phone:816-984-9410
Mailing Address - Fax:
Practice Address - Street 1:105 SW EAGLES PKWY
Practice Address - Street 2:
Practice Address - City:GRAIN VALLEY
Practice Address - State:MO
Practice Address - Zip Code:64029-8512
Practice Address - Country:US
Practice Address - Phone:816-265-1170
Practice Address - Fax:816-443-5692
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017025246235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist