Provider Demographics
NPI:1366642969
Name:GENARLSKY, PATRICIA (MS,CCC-SLP, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:GENARLSKY
Suffix:
Gender:F
Credentials:MS,CCC-SLP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7545 BOSQUE BLVD
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3713
Mailing Address - Country:US
Mailing Address - Phone:254-235-1850
Mailing Address - Fax:254-235-1144
Practice Address - Street 1:143 ELCO LN
Practice Address - Street 2:
Practice Address - City:CHINA SPRING
Practice Address - State:TX
Practice Address - Zip Code:76633-3080
Practice Address - Country:US
Practice Address - Phone:254-722-5236
Practice Address - Fax:254-836-0690
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21358235Z00000X
TX1-09-5269103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst