Provider Demographics
NPI:1700179488
Name:HEBERT, MARIA ELALINE (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ELALINE
Last Name:HEBERT
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 1:5723 MEEKS DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77632-1019
Mailing Address - Country:US
Mailing Address - Phone:409-886-2838
Mailing Address - Fax:409-886-8172
Practice Address - Street 1:5723 MEEKS DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77632-1019
Practice Address - Country:US
Practice Address - Phone:409-886-2838
Practice Address - Fax:409-886-8172
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15465235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist