Provider Demographics
NPI:1003191909
Name:ESTORGA, MELISSA ANGELICA (SLPA)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANGELICA
Last Name:ESTORGA
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 1:1301 E FERN AVE STE D1
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-1497
Mailing Address - Country:US
Mailing Address - Phone:956-683-9339
Mailing Address - Fax:956-683-9329
Practice Address - Street 1:1301 E FERN AVE STE D1
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-1497
Practice Address - Country:US
Practice Address - Phone:956-683-9339
Practice Address - Fax:956-683-9329
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX329522355A2700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology Assistant