Provider Demographics
NPI:1518693829
Name:MASSEY, MONICA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 W PECAN ST
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2518
Mailing Address - Country:US
Mailing Address - Phone:512-594-0000
Mailing Address - Fax:
Practice Address - Street 1:1401 W PECAN ST
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2518
Practice Address - Country:US
Practice Address - Phone:512-594-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-28
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118275235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist