Individual
ASEEDAW DEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC, SLP
Contact information
Practice address
1812 WELSH AVE, COLLEGE STATION, TX 77840-4800
(979) 764-5400
Mailing address
1812 WELSH AVE, COLLEGE STATION, TX 77840-4800
(979) 764-5400
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
106022
TX
235Z00000X
Speech-Language Pathologist
146012251
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106022
TEXAS DEPARTMENT OF LICENSING AND REGULATION
TX
01
—
146012251
STATE OF ILLINOIS DEPT. OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
10/30/2015
Last updated
10/27/2022
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