Provider Demographics
NPI:1447773833
Name:SALINAS, MARISA ISABELLA
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:ISABELLA
Last Name:SALINAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N SAM HOUSTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-4669
Mailing Address - Country:US
Mailing Address - Phone:956-536-5020
Mailing Address - Fax:
Practice Address - Street 1:5000 BEE CAVES RD STE 206
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5552
Practice Address - Country:US
Practice Address - Phone:512-284-8964
Practice Address - Fax:512-284-8966
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113741235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist