Provider Demographics
NPI:1194509877
Name:BARAJAS, BRITTANY MARIE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:BARAJAS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13945 S GREEN BAY AVE
Mailing Address - Street 2:
Mailing Address - City:BURNHAM
Mailing Address - State:IL
Mailing Address - Zip Code:60633-1671
Mailing Address - Country:US
Mailing Address - Phone:708-862-8636
Mailing Address - Fax:708-862-8638
Practice Address - Street 1:13945 S GREEN BAY AVE
Practice Address - Street 2:
Practice Address - City:BURNHAM
Practice Address - State:IL
Practice Address - Zip Code:60633-1671
Practice Address - Country:US
Practice Address - Phone:708-862-8636
Practice Address - Fax:708-862-8638
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2581021235Z00000X
IL146.017480235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist