Provider Demographics
NPI:1629725130
Name:DENNISON, MADISON KENDALL (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:KENDALL
Last Name:DENNISON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:MADDIE
Other - Middle Name:KENDALL
Other - Last Name:DENNISON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:7026 PONDHAWK DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-3930
Mailing Address - Country:US
Mailing Address - Phone:281-961-3598
Mailing Address - Fax:
Practice Address - Street 1:6301 S STADIUM LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1057
Practice Address - Country:US
Practice Address - Phone:281-396-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117140235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist