Provider Demographics
NPI:1588173934
Name:BRUNS, CECELIA (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:CECELIA
Middle Name:
Last Name:BRUNS
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8010 CLEARY BLVD APT 101
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1348
Mailing Address - Country:US
Mailing Address - Phone:757-403-3300
Mailing Address - Fax:757-403-3300
Practice Address - Street 1:5555 HOLLYWOOD BLVD STE 201
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6420
Practice Address - Country:US
Practice Address - Phone:954-603-1881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ8346235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist