Provider Demographics
NPI:1568129070
Name:ISAAC, MARTINA GARCELLA (MA CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:MARTINA
Middle Name:GARCELLA
Last Name:ISAAC
Suffix:
Gender:F
Credentials:MA CCC/SLP
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:500 W CARTWRIGHT RD APT 1222
Mailing Address - Street 2:
Mailing Address - City:BALCH SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75180-4846
Mailing Address - Country:US
Mailing Address - Phone:337-540-8608
Mailing Address - Fax:
Practice Address - Street 1:328 NEWSOM RD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-5056
Practice Address - Country:US
Practice Address - Phone:337-540-8608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist