Provider Demographics
NPI:1770553489
Name:EYER, BRIAN DAVID (CCC/SLP)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:DAVID
Last Name:EYER
Suffix:
Gender:M
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18905 N 44TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-3396
Mailing Address - Country:US
Mailing Address - Phone:623-760-5908
Mailing Address - Fax:623-466-0760
Practice Address - Street 1:1130 S 166TH AVE
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-6008
Practice Address - Country:US
Practice Address - Phone:623-760-5908
Practice Address - Fax:623-466-0760
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP4861235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist