Provider Demographics
NPI:1306183553
Name:TORRES, DOLORES GUADALUPE (MS CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:DOLORES
Middle Name:GUADALUPE
Last Name:TORRES
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N VALLEY PKWY STE 380
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3472
Mailing Address - Country:US
Mailing Address - Phone:972-353-5437
Mailing Address - Fax:
Practice Address - Street 1:401 N VALLEY PKWY
Practice Address - Street 2:STE 380
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3921
Practice Address - Country:US
Practice Address - Phone:972-353-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105818235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist