Provider Demographics
NPI:1023274016
Name:WARREN, BRENDA LEE-MASON (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LEE-MASON
Last Name:WARREN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 W. FRONT ST.
Mailing Address - Street 2:B.
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215
Mailing Address - Country:US
Mailing Address - Phone:336-516-3021
Mailing Address - Fax:336-513-0326
Practice Address - Street 1:1114 W. FRONT ST.
Practice Address - Street 2:B.
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215
Practice Address - Country:US
Practice Address - Phone:336-516-3021
Practice Address - Fax:336-513-0326
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist