Provider Demographics
NPI:1104292523
Name:PRINCE, BRITTNEY SIMONE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:BRITTNEY
Middle Name:SIMONE
Last Name:PRINCE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 VARIEL AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-2569
Mailing Address - Country:US
Mailing Address - Phone:202-702-1882
Mailing Address - Fax:
Practice Address - Street 1:1900 W OLIVE AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2438
Practice Address - Country:US
Practice Address - Phone:818-729-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA08319235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist