Basic Information
| Provider Information | |||||||||
| NPI: | 1871894477 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TODD | ||||||||
| FirstName: | BRENDA | ||||||||
| MiddleName: | V | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5000 CHESHIRE PKWY N | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554464103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8885100766 | ||||||||
| FaxNumber: | 7632684430 | ||||||||
| Practice Location | |||||||||
| Address1: | 11516 SE MILL PLAIN BLVD STE J | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986845082 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3608828027 | ||||||||
| FaxNumber: | 3608828030 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/12/2010 | ||||||||
| LastUpdateDate: | 08/31/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | HA60091338 | WA | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.