Provider Demographics
NPI:1053929679
Name:BREZINA, EMILY ANN
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:BREZINA
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 1:4400 COLLEGE PARK DR APT 817
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4376
Mailing Address - Country:US
Mailing Address - Phone:713-806-5536
Mailing Address - Fax:
Practice Address - Street 1:19241 DAVID MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-8786
Practice Address - Country:US
Practice Address - Phone:936-321-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist