Provider Demographics
NPI:1346531647
Name:ONGLEY, BRENDA IRENE (CCC - SLP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:IRENE
Last Name:ONGLEY
Suffix:
Gender:F
Credentials:CCC - SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24600 SILVER CLOUD CT
Mailing Address - Street 2:STE 104
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-6555
Mailing Address - Country:US
Mailing Address - Phone:831-645-7900
Mailing Address - Fax:831-645-7906
Practice Address - Street 1:217 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-8823
Practice Address - Country:US
Practice Address - Phone:719-687-9335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12092170235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist