Provider Demographics
NPI:1396388104
Name:FUCHS, ELLEN RHETT (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:RHETT
Last Name:FUCHS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:RHETT
Other - Last Name:RUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:5800 BROADWAY ST STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-5257
Mailing Address - Country:US
Mailing Address - Phone:210-827-0239
Mailing Address - Fax:
Practice Address - Street 1:5800 BROADWAY ST STE 106
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-5257
Practice Address - Country:US
Practice Address - Phone:210-827-0239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112029235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist