Individual
MS. SAMANTHA BRUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
5447 WOODWARD AVE, DETROIT, MI 48202-4009
(313) 832-1100
(313) 578-4520
Mailing address
5447 WOODWARD AVE, DETROIT, MI 48202-4009
(313) 832-1100
(313) 578-4520
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09135442
NATIONAL SPEECH AND LANGUAGE CERTIFICATION
—
Enumeration date
06/03/2009
Last updated
06/03/2009
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