Basic Information
| Provider Information | |||||||||
| NPI: | 1063749620 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HENDRY | ||||||||
| FirstName: | ALYSON | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3050 TAMARRON BLVD | ||||||||
| Address2: | APT # 1106 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787468035 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 9607 RESEACH BLVD. | ||||||||
| Address2: | SUITE 675 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5125279608 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2009 | ||||||||
| LastUpdateDate: | 11/03/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 105203 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.