Provider Demographics
NPI:1407437635
Name:ALLEN, BRIANNA MARIE (MS)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MARIE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 S 80 E STE 110
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-7090
Mailing Address - Country:US
Mailing Address - Phone:435-557-0234
Mailing Address - Fax:
Practice Address - Street 1:640 S 80 E STE 110
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-7090
Practice Address - Country:US
Practice Address - Phone:435-557-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-5327235Z00000X
UT13944809-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist