Provider Demographics
NPI:1538509211
Name:ARNOLD, TASIA RENEE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TASIA
Middle Name:RENEE
Last Name:ARNOLD
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 1:16507 CABALLO VLY
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:TX
Mailing Address - Zip Code:78154-3880
Mailing Address - Country:US
Mailing Address - Phone:210-213-3578
Mailing Address - Fax:
Practice Address - Street 1:16507 CABALLO VLY
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:TX
Practice Address - Zip Code:78154-3880
Practice Address - Country:US
Practice Address - Phone:210-213-3578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104603235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist