Provider Demographics
NPI:1740945914
Name:FAUCETT, MADELYN KAY (MS-CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MADELYN
Middle Name:KAY
Last Name:FAUCETT
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:PARIS INDEPENDENT SCHOOL DISTRICT SPECIAL POPULATIONS
Mailing Address - Street 2:3480 GRAHAM STREET
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460
Mailing Address - Country:US
Mailing Address - Phone:903-737-7494
Mailing Address - Fax:903-783-1030
Practice Address - Street 1:PARIS INDEPENDENT SCHOOL DISTRICT SPECIAL POPULATIONS
Practice Address - Street 2:3480 GRAHAM STREET
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460
Practice Address - Country:US
Practice Address - Phone:903-737-7494
Practice Address - Fax:903-783-1030
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18830235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist