Provider Demographics
NPI:1477097145
Name:GOLDFARB, RYSSE BAYER (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RYSSE
Middle Name:BAYER
Last Name:GOLDFARB
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 1:4455 CULLEN BLVD.
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77204-6018
Mailing Address - Country:US
Mailing Address - Phone:713-743-0915
Mailing Address - Fax:713-743-2926
Practice Address - Street 1:4455 CULLEN BLVD.
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77204-6018
Practice Address - Country:US
Practice Address - Phone:713-743-0915
Practice Address - Fax:713-743-2926
Is Sole Proprietor?:No
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102403235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist