Provider Demographics
NPI:1316489651
Name:BRENSON, ANNA M (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:BRENSON
Suffix:
Gender:
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:M
Other - Last Name:VILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4330 S LEIGHTON CIR
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76309-4709
Mailing Address - Country:US
Mailing Address - Phone:713-865-3830
Mailing Address - Fax:713-865-3830
Practice Address - Street 1:4330 S LEIGHTON CIR
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76309-4709
Practice Address - Country:US
Practice Address - Phone:713-865-3830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120140235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist