Provider Demographics
NPI:1538865167
Name:WIMBERLEY, TONICIA
Entity type:Individual
Prefix:
First Name:TONICIA
Middle Name:
Last Name:WIMBERLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1523 FASHION HILL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-5028
Mailing Address - Country:US
Mailing Address - Phone:832-859-8283
Mailing Address - Fax:
Practice Address - Street 1:1523 FASHION HILL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-5028
Practice Address - Country:US
Practice Address - Phone:832-859-8283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist