Provider Demographics
NPI:1699452524
Name:TRIPOLI, BRIANNA ALLYCE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:ALLYCE
Last Name:TRIPOLI
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 1:37 FRIEND ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-3068
Mailing Address - Country:US
Mailing Address - Phone:781-715-6608
Mailing Address - Fax:
Practice Address - Street 1:62 MARKET ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1005
Practice Address - Country:US
Practice Address - Phone:781-595-4717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASLP77673235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist