Provider Demographics
NPI:1417679267
Name:SLADE, JOYCE HELEN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:HELEN
Last Name:SLADE
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 1:2300 YORKSTOWN DR APT 103E
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-8206
Mailing Address - Country:US
Mailing Address - Phone:972-977-7747
Mailing Address - Fax:
Practice Address - Street 1:2200 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-4088
Practice Address - Country:US
Practice Address - Phone:903-602-7441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17602235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist