Provider Demographics
NPI:1215210919
Name:YOOSUFANI, AYESHA K (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:AYESHA
Middle Name:K
Last Name:YOOSUFANI
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21003 INTERSTATE 35
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-4745
Mailing Address - Country:US
Mailing Address - Phone:512-268-8250
Mailing Address - Fax:
Practice Address - Street 1:21003 INTERSTATE 35
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-4745
Practice Address - Country:US
Practice Address - Phone:512-268-8250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist