Provider Demographics
NPI:1700514528
Name:MEANS, MARY ALICIA (MA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ALICIA
Last Name:MEANS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 TANGERINE DR
Mailing Address - Street 2:
Mailing Address - City:PALM VALLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78552-9019
Mailing Address - Country:US
Mailing Address - Phone:956-873-0716
Mailing Address - Fax:
Practice Address - Street 1:600 N AUSTIN ST
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-4700
Practice Address - Country:US
Practice Address - Phone:956-361-6221
Practice Address - Fax:956-361-6222
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist