Individual
BREANN TNAE POOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ST
Contact information
Practice address
3501 S SONCY RD STE 137, AMARILLO, TX 79119-6406
(806) 331-6084
Mailing address
8726 LUPINE, AMARILLO, TX 79119-1189
(806) 331-6084
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14036703
LICENSE
TX
Enumeration date
10/11/2019
Last updated
10/14/2019
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