Individual
BRIEANNA PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17401 WESTBURY DR, LOUISVILLE, KY 40245-5483
(336) 707-0090
Mailing address
17401 WESTBURY DR, LOUISVILLE, KY 40245-5483
(336) 707-0090
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
272935
KENTUCKY BOARD OF SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY LICENCE
KY
Enumeration date
06/23/2020
Last updated
12/16/2021
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