Provider Demographics
NPI:1124340823
Name:BRIAN, IRIT (MSSLP/CCC)
Entity type:Individual
Prefix:MRS
First Name:IRIT
Middle Name:
Last Name:BRIAN
Suffix:
Gender:F
Credentials:MSSLP/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25768 HAWTHORNE PL
Mailing Address - Street 2:
Mailing Address - City:STEVENSON RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91381-1451
Mailing Address - Country:US
Mailing Address - Phone:661-753-7634
Mailing Address - Fax:
Practice Address - Street 1:25768 HAWTHORNE PL
Practice Address - Street 2:
Practice Address - City:STEVENSON RANCH
Practice Address - State:CA
Practice Address - Zip Code:91381-1451
Practice Address - Country:US
Practice Address - Phone:661-753-7634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8284235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist