Provider Demographics
NPI:1902653520
Name:RAPP, BREAH (MS)
Entity type:Individual
Prefix:
First Name:BREAH
Middle Name:
Last Name:RAPP
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:BREAH
Other - Middle Name:
Other - Last Name:BUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3130 COURTHOUSE DR E APT 1A
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-1018
Mailing Address - Country:US
Mailing Address - Phone:469-237-0695
Mailing Address - Fax:
Practice Address - Street 1:1903 UNION ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-2627
Practice Address - Country:US
Practice Address - Phone:765-588-5615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN46004390A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist