Individual
CHANEL MARIE EISENDRATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6005 RELIANCE RIDGE CIR, BRYAN, TX 77808-1545
(307) 250-4730
Mailing address
6005 RELIANCE RIDGE CIR, BRYAN, TX 77808-1545
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
121865
TX
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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