Provider Demographics
NPI:1295903177
Name:GALICKI, WENDY YANETTE (SLP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:YANETTE
Last Name:GALICKI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5621 CEDAR TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-1219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2550 W EXPY 83
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-7001
Practice Address - Country:US
Practice Address - Phone:956-361-5437
Practice Address - Fax:956-361-5440
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100235235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist