Provider Demographics
NPI:1134323744
Name:GUERRA, MELINDA ANNETTE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:ANNETTE
Last Name:GUERRA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 NORTHGATE LN
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-9558
Mailing Address - Country:US
Mailing Address - Phone:956-631-6200
Mailing Address - Fax:956-631-6433
Practice Address - Street 1:3601 BUDDY OWENS BOULEVARD
Practice Address - Street 2:SUITE 100
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6447
Practice Address - Country:US
Practice Address - Phone:956-631-6200
Practice Address - Fax:956-631-6433
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14949235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist