Provider Demographics
NPI:1104602853
Name:STUART, BRIANNA
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:STUART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:
Other - Last Name:FONTAINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1308 NUMBER 12 RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT CENTER
Mailing Address - State:VT
Mailing Address - Zip Code:05857-9336
Mailing Address - Country:US
Mailing Address - Phone:802-673-0211
Mailing Address - Fax:
Practice Address - Street 1:1308 NUMBER 12 RD
Practice Address - Street 2:
Practice Address - City:NEWPORT CENTER
Practice Address - State:VT
Practice Address - Zip Code:05857-9336
Practice Address - Country:US
Practice Address - Phone:802-673-0211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist