Provider Demographics
NPI:1174220966
Name:COX, BRIANA NICOLE-LYNN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:BRIANA
Middle Name:NICOLE-LYNN
Last Name:COX
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:BRIANA
Other - Middle Name:NICOLE-LYN
Other - Last Name:PELLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CF-SLP
Mailing Address - Street 1:3700 OLD GREENBRIER PIKE APT 607
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-5075
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:215 DUNBAR CAVE RD STE A
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-8850
Practice Address - Country:US
Practice Address - Phone:267-567-0789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7619235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14323528OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION (ASHA) CERTIFICATION
TN7619OtherTN STATE SLP LICENSE