Provider Demographics
NPI:1831757434
Name:BRATTEN, LUCINDY (AUD)
Entity type:Individual
Prefix:
First Name:LUCINDY
Middle Name:
Last Name:BRATTEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 HARBOR TREE DR
Mailing Address - Street 2:
Mailing Address - City:CROWNSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21032-1529
Mailing Address - Country:US
Mailing Address - Phone:443-538-6033
Mailing Address - Fax:
Practice Address - Street 1:8460 SAVAGE GUILFORD RD
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MD
Practice Address - Zip Code:20763-9651
Practice Address - Country:US
Practice Address - Phone:443-538-6033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00740231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist