Provider Demographics
NPI:1245084714
Name:NESBITT, MARIA STAMATIS (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:STAMATIS
Last Name:NESBITT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:KATHERINE
Other - Last Name:STAMATIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:6115 39TH ST
Mailing Address - Street 2:
Mailing Address - City:GROVES
Mailing Address - State:TX
Mailing Address - Zip Code:77619-4612
Mailing Address - Country:US
Mailing Address - Phone:409-237-4181
Mailing Address - Fax:
Practice Address - Street 1:6115 39TH ST
Practice Address - Street 2:
Practice Address - City:GROVES
Practice Address - State:TX
Practice Address - Zip Code:77619-4612
Practice Address - Country:US
Practice Address - Phone:409-237-4181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117160235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist