Provider Demographics
NPI:1417563412
Name:FLORES, SOLEDAD (SLP-ASSITANT)
Entity Type:Individual
Prefix:
First Name:SOLEDAD
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:SLP-ASSITANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4210 US HIGHWAY 80 E APT 2031
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-9063
Mailing Address - Country:US
Mailing Address - Phone:501-269-4768
Mailing Address - Fax:
Practice Address - Street 1:4210 US HIGHWAY 80 E APT 2031
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-9063
Practice Address - Country:US
Practice Address - Phone:501-269-4768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX411452355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant