Provider Demographics
NPI:1912329723
Name:BRANDY GIVAN
Entity type:Organization
Organization Name:BRANDY GIVAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:270-307-1522
Mailing Address - Street 1:108 CAREY LN
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2602
Mailing Address - Country:US
Mailing Address - Phone:270-307-1522
Mailing Address - Fax:270-209-0412
Practice Address - Street 1:108 CAREY LN
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2602
Practice Address - Country:US
Practice Address - Phone:270-307-1522
Practice Address - Fax:270-209-0412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency