Provider Demographics
NPI:1841964103
Name:MARSHALL, BRENNA MARIE (AUD, CCC-A, FAAA)
Entity type:Individual
Prefix:DR
First Name:BRENNA
Middle Name:MARIE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:AUD, CCC-A, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 W 6TH ST STE 216
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2249
Mailing Address - Country:US
Mailing Address - Phone:785-841-1107
Mailing Address - Fax:785-841-1173
Practice Address - Street 1:1112 W 6TH ST STE 216
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2249
Practice Address - Country:US
Practice Address - Phone:785-841-1107
Practice Address - Fax:785-841-1173
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2424231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist