Provider Demographics
NPI:1710555685
Name:QUATTLEBAUM, TRESSIA (MA CF-SLP)
Entity Type:Individual
Prefix:
First Name:TRESSIA
Middle Name:
Last Name:QUATTLEBAUM
Suffix:
Gender:F
Credentials:MA CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 GREENBRIAR DR APT 2039
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4530
Mailing Address - Country:US
Mailing Address - Phone:346-247-9619
Mailing Address - Fax:
Practice Address - Street 1:8021 BISSONNET ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-5200
Practice Address - Country:US
Practice Address - Phone:713-774-5437
Practice Address - Fax:713-774-5437
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118207235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist