Provider Demographics
NPI:1558167262
Name:AGGISON, TANYA (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:
Last Name:AGGISON
Suffix:
Gender:
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 1:7910 SYDNEY BAY CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1493
Mailing Address - Country:US
Mailing Address - Phone:281-704-4676
Mailing Address - Fax:
Practice Address - Street 1:7910 SYDNEY BAY CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-1493
Practice Address - Country:US
Practice Address - Phone:281-704-4676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24840235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist