Provider Demographics
NPI:1346242336
Name:MENA, DEANNA RODRIGUEZ (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:RODRIGUEZ
Last Name:MENA
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 1:9343 NORTH LOOP E
Mailing Address - Street 2:SUITE 226
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-1251
Mailing Address - Country:US
Mailing Address - Phone:713-674-5003
Mailing Address - Fax:713-674-5009
Practice Address - Street 1:9343 NORTH LOOP E
Practice Address - Street 2:SUITE 226
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-1251
Practice Address - Country:US
Practice Address - Phone:713-674-5003
Practice Address - Fax:713-674-5009
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100316235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist