Provider Demographics
NPI:1265671168
Name:SZYMCZAK, DENISE LYNETTE (MA, CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:LYNETTE
Last Name:SZYMCZAK
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909B E LIVE OAK ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-5235
Mailing Address - Country:US
Mailing Address - Phone:512-576-4388
Mailing Address - Fax:
Practice Address - Street 1:909B E LIVE OAK ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-5235
Practice Address - Country:US
Practice Address - Phone:512-576-4388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17796235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist