Provider Demographics
NPI:1295124139
Name:COODY, PERLA (SLPA)
Entity type:Individual
Prefix:
First Name:PERLA
Middle Name:
Last Name:COODY
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 W SAINT FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:TX
Mailing Address - Zip Code:78573-4108
Mailing Address - Country:US
Mailing Address - Phone:956-222-7890
Mailing Address - Fax:
Practice Address - Street 1:35 BUSINESS DR STE D
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-4587
Practice Address - Country:US
Practice Address - Phone:956-541-6976
Practice Address - Fax:186-694-5943
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX372712355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant