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Individual

BRYN PETTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
2211 I 35 SOUTH, SUITE 300, AUSTIN, TX 78741
(512) 394-0652
Mailing address
145 TEAL LAKE DR, RICHMOND HILL, GA 31324-3518
(817) 433-0721

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149984001
TX
Enumeration date
08/09/2010
Last updated
08/09/2010
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