Provider Demographics
NPI:1164186102
Name:PILLADO, MARIA DE JESUS (CCC-SLP, BILINGUAL)
Entity Type:Individual
Prefix:
First Name:MARIA DE JESUS
Middle Name:
Last Name:PILLADO
Suffix:
Gender:F
Credentials:CCC-SLP, BILINGUAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W RYAN RD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-5521
Mailing Address - Country:US
Mailing Address - Phone:817-578-6926
Mailing Address - Fax:
Practice Address - Street 1:201 W RYAN RD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-5521
Practice Address - Country:US
Practice Address - Phone:817-578-6926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111995235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist