Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Brandi Marisa Bazemore Ellis, MSCCC-SLP

Individual provider Speech-Language Pathologist · NPI 1659992808

Mrs. Brandi Marisa Bazemore Ellis, MSCCC-SLP is a Speech-Language Pathologist in Statesboro, Georgia. Works from 2 locations. Licensed in Georgia.

Licensed in
GA
In the registry since
2020
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Practice location Address checks out

508 Gentilly Rd
Statesboro, GA 30458-5149
Phone: (912) 681-7768
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9104 Savannah Hwy, Newington, GA 30446-2603 — (912) 665-2690

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SLP009766 (GA)

Record details

NPI number1659992808
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSCCC-SLP
Sole proprietorNo
NPI enumeratedApril 29, 2020
Last updated in NPPESApril 29, 2020
Certification dateApril 29, 2020

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