Provider Demographics
NPI:1366878209
Name:MUNLEY, BRENDA HOLLINGSWORTH (MS)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:HOLLINGSWORTH
Last Name:MUNLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:LEE
Other - Last Name:HOLLINGSWORTH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:615 SNOW AVE
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-3851
Mailing Address - Country:US
Mailing Address - Phone:509-967-6000
Mailing Address - Fax:
Practice Address - Street 1:615 SNOW AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3851
Practice Address - Country:US
Practice Address - Phone:509-967-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00003426235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist