Provider Demographics
NPI:1689825580
Name:FRIESENHAHN, DENISE ESTELLE (MEDCCC/SLP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:ESTELLE
Last Name:FRIESENHAHN
Suffix:
Gender:F
Credentials:MEDCCC/SLP
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:ESTELLE
Other - Last Name:SIMECKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MEDCCC/SLP
Mailing Address - Street 1:15316 HUEBNER RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-0994
Mailing Address - Country:US
Mailing Address - Phone:210-614-4567
Mailing Address - Fax:210-614-4999
Practice Address - Street 1:4095 DEZAVALA RD
Practice Address - Street 2:
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78249-2066
Practice Address - Country:US
Practice Address - Phone:210-493-8100
Practice Address - Fax:210-493-8154
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13760235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist