Provider Demographics
NPI:1669803672
Name:GOETZEL, DENISE (MS, CCC/SLP)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:GOETZEL
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 N TEXAS BLVD
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-5039
Mailing Address - Country:US
Mailing Address - Phone:361-396-4861
Mailing Address - Fax:361-356-4373
Practice Address - Street 1:408 N TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-5039
Practice Address - Country:US
Practice Address - Phone:361-396-4861
Practice Address - Fax:361-356-4373
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18660235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist