Individual
BRENNA FIRESTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
10640 N RIVERSIDE DR STE 200, FORT WORTH, TX 76244-9506
(817) 431-9000
(817) 796-2781
Mailing address
10640 N RIVERSIDE DR STE 200, FORT WORTH, TX 76244-9506
(817) 431-9000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
119514
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119514
SPEECH THERAPY LICENSE
TX
Enumeration date
04/06/2023
Last updated
08/31/2023
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