Provider Demographics
NPI:1477084531
Name:NELMS, MARTHA MARIE (MS/CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:MARIE
Last Name:NELMS
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:MS
Other - First Name:MARTHA
Other - Middle Name:MARIE
Other - Last Name:NORWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS/CCC-SLP
Mailing Address - Street 1:2001 N MACARTHUR BLVD STE 550
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061
Mailing Address - Country:US
Mailing Address - Phone:972-579-8155
Mailing Address - Fax:972-579-4398
Practice Address - Street 1:4901 BRYANT IRVIN RD N
Practice Address - Street 2:200
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-7673
Practice Address - Country:US
Practice Address - Phone:817-738-9866
Practice Address - Fax:817-738-3157
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106520235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist