Provider Demographics
NPI:1962552935
Name:SANTA MARIA, BRENDA (SLP)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:SANTA MARIA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:597 N FM 3167
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-6738
Mailing Address - Country:US
Mailing Address - Phone:569-735-9431
Mailing Address - Fax:
Practice Address - Street 1:608 NORTH GARCIA STREET
Practice Address - Street 2:
Practice Address - City:ROMA
Practice Address - State:TX
Practice Address - Zip Code:78584
Practice Address - Country:US
Practice Address - Phone:956-849-1616
Practice Address - Fax:956-488-1819
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist