Provider Demographics
NPI:1093404469
Name:YZNAGA, TERRI ANN (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:ANN
Last Name:YZNAGA
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8306 PARRY PATH
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-3281
Mailing Address - Country:US
Mailing Address - Phone:210-454-7916
Mailing Address - Fax:
Practice Address - Street 1:16400 BLANCO RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1902
Practice Address - Country:US
Practice Address - Phone:210-572-4954
Practice Address - Fax:210-699-7995
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16279235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist