Provider Demographics
NPI:1003567538
Name:FIGUEROA AYALA, CARMEN CRISTINA
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:CRISTINA
Last Name:FIGUEROA AYALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 FORT WORTH AVE APT 3301
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-1815
Mailing Address - Country:US
Mailing Address - Phone:787-678-0146
Mailing Address - Fax:
Practice Address - Street 1:2424 FORT WORTH AVE APT 3301
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-1815
Practice Address - Country:US
Practice Address - Phone:787-678-0146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117380235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist