Basic Information
Provider Information
NPI: 1730583246
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAENZ
FirstName: MARLEYNA
MiddleName:  
NamePrefix: MISS
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 305 NE LOOP 820
Address2: BUSINESS TOWER 1, SUITE 200
City: HURST
State: TX
PostalCode: 76053
CountryCode: US
TelephoneNumber: 8172928787
FaxNumber: 8177896849
Practice Location
Address1: 98 BRIGGS AVENUE
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 78224
CountryCode: US
TelephoneNumber: 2102269536
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/13/2014
LastUpdateDate: 10/13/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2355S0801X38054TXY Speech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant

No ID Information.


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