Provider Demographics
NPI:1538390927
Name:SARGENT, BRIENNE (SLP)
Entity type:Individual
Prefix:
First Name:BRIENNE
Middle Name:
Last Name:SARGENT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 CHRISTOPHER WREN DR
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7366
Mailing Address - Country:US
Mailing Address - Phone:304-281-4667
Mailing Address - Fax:
Practice Address - Street 1:7000 CHRISTOPHER WREN DR
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7366
Practice Address - Country:US
Practice Address - Phone:304-281-4667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009610235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist