Provider Demographics
NPI:1457023665
Name:GOMEZ CANTRELL, SARIKA (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:SARIKA
Middle Name:
Last Name:GOMEZ CANTRELL
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 1:3200 WHEELING AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79930-4399
Mailing Address - Country:US
Mailing Address - Phone:915-236-8675
Mailing Address - Fax:
Practice Address - Street 1:3200 WHEELING AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79930-4399
Practice Address - Country:US
Practice Address - Phone:915-236-8675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19014235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist