Provider Demographics
NPI:1902545825
Name:DELP, TRENTON MITCHELL (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TRENTON
Middle Name:MITCHELL
Last Name:DELP
Suffix:
Gender:M
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 1:260 S BROOK DR APT 1527
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-5094
Mailing Address - Country:US
Mailing Address - Phone:712-291-1009
Mailing Address - Fax:
Practice Address - Street 1:2500 W WILLIAM CANNON DR STE 804
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5349
Practice Address - Country:US
Practice Address - Phone:512-733-9541
Practice Address - Fax:855-941-2551
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118554235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist