Provider Demographics
NPI:1114417896
Name:LOZA, CELINA KATHLEEN (SLP-ASSISTANT)
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:KATHLEEN
Last Name:LOZA
Suffix:
Gender:F
Credentials:SLP-ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 454
Mailing Address - Street 2:
Mailing Address - City:NATALIA
Mailing Address - State:TX
Mailing Address - Zip Code:78059-0454
Mailing Address - Country:US
Mailing Address - Phone:210-623-0135
Mailing Address - Fax:
Practice Address - Street 1:505 4TH STREET
Practice Address - Street 2:
Practice Address - City:NATALIA
Practice Address - State:TX
Practice Address - Zip Code:78059-0454
Practice Address - Country:US
Practice Address - Phone:210-623-0135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX402722355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant