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NPI 1912134883

NPI 1912134883 : MS. TRENA SUE COCKRELL-SANTEE : AMARILLO, TX

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General NPI Number Information
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    NPI Number           |    1912134883
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    Entity Type          |    Individual 
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    Provider Name        |    MS. TRENA SUE COCKRELL-SANTEE
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/17/2009
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    Last Update Date     |    09/06/2018
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Provider Practice Location Address
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    Address Line         |    1601 KIRKLAND DR 
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    City                 |    AMARILLO
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    State                |    TX
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    Zip                  |    79106
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    Country              |    US
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    Telephone            |    785-250-1200
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1601 KIRKLAND DR 
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    City                 |    AMARILLO
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    State                |    TX
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    Zip                  |    79106-2401
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    Country              |    US
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    Telephone            |    316-250-1200
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    0094
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    License Number State |    KS
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Taxonomy #2
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    108410
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    License Number State |    TX
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