Provider Demographics
NPI:1326317751
Name:HARMON, BRENDA CARMICKLE (MS, CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:CARMICKLE
Last Name:HARMON
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:MS
Other - First Name:BRENDA
Other - Middle Name:MAE
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC/SLP
Mailing Address - Street 1:2805 BISSONET DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-8030
Mailing Address - Country:US
Mailing Address - Phone:940-536-1367
Mailing Address - Fax:
Practice Address - Street 1:2805 BISSONET DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-8030
Practice Address - Country:US
Practice Address - Phone:940-536-1367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13257235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist