Organization
SPEECH THERAPY UNBOXED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BREANNA NELSON M.S. CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(703) 217-9331
Entity
Organization
Contact information
Practice address
447 N 300 W STE 8, KAYSVILLE, UT 84037-4203
(703) 217-9331
Mailing address
265 N MAIN ST, STE D #191, KAYSVILLE, UT 84037
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6574955-4102
UT
Other
Enumeration date
07/13/2017
Last updated
07/13/2017
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