Provider Demographics
NPI:1548939119
Name:STEPHENSON, BRANDI BETH (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:BETH
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 PARKSIDE VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-3811
Mailing Address - Country:US
Mailing Address - Phone:281-703-8363
Mailing Address - Fax:
Practice Address - Street 1:3010 HARKEY RD
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-2961
Practice Address - Country:US
Practice Address - Phone:281-412-1412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100909235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist