Provider Demographics
NPI:1881825560
Name:COLEY, BRENDA (AUD)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:COLEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4351 BOOTH CALLOWAY RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-7378
Mailing Address - Country:US
Mailing Address - Phone:817-595-3700
Mailing Address - Fax:817-595-3701
Practice Address - Street 1:4351 BOOTH CALLOWAY RD
Practice Address - Street 2:SUITE 400
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-7378
Practice Address - Country:US
Practice Address - Phone:817-595-3700
Practice Address - Fax:817-595-3701
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80089231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist