Provider Demographics
NPI:1326033481
Name:BLISS, BRENDA WEINFELD (MSCCC-SLP/A)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:WEINFELD
Last Name:BLISS
Suffix:
Gender:F
Credentials:MSCCC-SLP/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 HILLCREST RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2033
Mailing Address - Country:US
Mailing Address - Phone:972-387-2824
Mailing Address - Fax:972-387-9097
Practice Address - Street 1:12700 HILLCREST RD
Practice Address - Street 2:SUITE 207
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2033
Practice Address - Country:US
Practice Address - Phone:972-387-2824
Practice Address - Fax:972-387-9097
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15193235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist