Provider Demographics
NPI:1326769167
Name:REYNA, JOSEFINA (CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOSEFINA
Middle Name:
Last Name:REYNA
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:MS
Other - First Name:JOSEFINA
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC/SLP
Mailing Address - Street 1:2103 JOY ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6061
Mailing Address - Country:US
Mailing Address - Phone:956-279-3262
Mailing Address - Fax:
Practice Address - Street 1:3221 OLGA AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-8705
Practice Address - Country:US
Practice Address - Phone:956-971-1167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist