Provider Demographics
NPI:1962058248
Name:FISCHER, BRYNLEE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:BRYNLEE
Middle Name:
Last Name:FISCHER
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 1:5305 AVALON CT
Mailing Address - Street 2:
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1060
Mailing Address - Country:US
Mailing Address - Phone:908-907-3497
Mailing Address - Fax:
Practice Address - Street 1:5305 AVALON CT
Practice Address - Street 2:
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1060
Practice Address - Country:US
Practice Address - Phone:908-907-3497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00937500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist