Provider Demographics
NPI:1184498487
Name:GRATZ, ALISON (CCC/SLP)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:GRATZ
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4710 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3948
Mailing Address - Country:US
Mailing Address - Phone:281-384-6149
Mailing Address - Fax:
Practice Address - Street 1:302 MARTIN LN
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-1445
Practice Address - Country:US
Practice Address - Phone:281-384-6149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100104235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist