Provider Demographics
NPI:1801575816
Name:BRAINSTORM CONSULTING LLC
Entity type:Organization
Organization Name:BRAINSTORM CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:GUTIERREZ VANEGAS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:202-374-8192
Mailing Address - Street 1:301 W BROAD ST APT 665
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3376
Mailing Address - Country:US
Mailing Address - Phone:202-374-8192
Mailing Address - Fax:
Practice Address - Street 1:307 E ANNANDALE ROAD
Practice Address - Street 2:208
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042
Practice Address - Country:US
Practice Address - Phone:202-417-6609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech