Provider Demographics
NPI:1578063012
Name:WILLIS, ARLETTA (SLP-A)
Entity Type:Individual
Prefix:
First Name:ARLETTA
Middle Name:
Last Name:WILLIS
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:ARLETTE
Other - Middle Name:
Other - Last Name:WILLIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP-A
Mailing Address - Street 1:18600 S PARKVIEW DR APT 2121
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-6148
Mailing Address - Country:US
Mailing Address - Phone:337-303-6530
Mailing Address - Fax:
Practice Address - Street 1:18600 S PARKVIEW DR APT 2121
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-6148
Practice Address - Country:US
Practice Address - Phone:337-303-6530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX394952355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant