Provider Demographics
NPI:1699441485
Name:HERSCHELMAN, BRIANNA MARIE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:MARIE
Last Name:HERSCHELMAN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E BEACH ST
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62056-1500
Mailing Address - Country:US
Mailing Address - Phone:217-820-1914
Mailing Address - Fax:
Practice Address - Street 1:202 PRAIRIE ST
Practice Address - Street 2:
Practice Address - City:MORRISONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62546
Practice Address - Country:US
Practice Address - Phone:217-526-8121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.015280235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist