Provider Demographics
NPI:1528817285
Name:DE LA PAZ, BRENDA LIZETH (SLPA)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LIZETH
Last Name:DE LA PAZ
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7104 COUNTY ROAD 153
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-7419
Mailing Address - Country:US
Mailing Address - Phone:469-500-7526
Mailing Address - Fax:
Practice Address - Street 1:930 W CENTERVILLE RD STE C
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5854
Practice Address - Country:US
Practice Address - Phone:972-303-7021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
438002355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant