Individual
BREANNA L BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
80 PROFESSIONAL CT, LAFAYETTE, IN 47905-5152
(765) 448-1758
(765) 448-3898
Mailing address
80 PROFESSIONAL CT, LAFAYETTE, IN 47905-5152
(765) 448-1758
(765) 448-3898
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
46002126A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2205442A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
01
—
46002126A
IN CF LICENSE
IN
Enumeration date
01/26/2011
Last updated
07/07/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us