Provider Demographics
NPI:1972250207
Name:HESSEL, AMELIA (MHSC, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:HESSEL
Suffix:
Gender:F
Credentials:MHSC, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4770 FORGET ME NOT RD
Mailing Address - Street 2:
Mailing Address - City:GILMER
Mailing Address - State:TX
Mailing Address - Zip Code:75644-6130
Mailing Address - Country:US
Mailing Address - Phone:903-767-8315
Mailing Address - Fax:
Practice Address - Street 1:4770 FORGET ME NOT RD
Practice Address - Street 2:
Practice Address - City:GILMER
Practice Address - State:TX
Practice Address - Zip Code:75644-6130
Practice Address - Country:US
Practice Address - Phone:903-767-8315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119244235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist