Provider Demographics
NPI:1316981459
Name:MYERS, BRE LYNN (MS, FAAA)
Entity type:Individual
Prefix:
First Name:BRE
Middle Name:LYNN
Last Name:MYERS
Suffix:
Gender:F
Credentials:MS, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BIRDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19508-2212
Mailing Address - Country:US
Mailing Address - Phone:610-404-1584
Mailing Address - Fax:
Practice Address - Street 1:309 W 2ND ST
Practice Address - Street 2:
Practice Address - City:BIRDSBORO
Practice Address - State:PA
Practice Address - Zip Code:19508-2212
Practice Address - Country:US
Practice Address - Phone:610-404-1584
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT005895231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist