Provider Demographics
NPI:1093983744
Name:CANALES, PRISCILLA S (SLP ASSISTANT)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:S
Last Name:CANALES
Suffix:
Gender:F
Credentials:SLP ASSISTANT
Other - Prefix:
Other - First Name:PRISCILLA
Other - Middle Name:
Other - Last Name:CANALES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLP ASSISTANT
Mailing Address - Street 1:1018 E KATHY ST
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-2618
Mailing Address - Country:US
Mailing Address - Phone:956-325-6927
Mailing Address - Fax:956-383-2975
Practice Address - Street 1:1018 E KATHY ST
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-2618
Practice Address - Country:US
Practice Address - Phone:956-325-6927
Practice Address - Fax:956-383-2975
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX336162355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX33616OtherSTATE BOARD OF EXAMINERS