Provider Demographics
NPI:1477112613
Name:QUINTANILLA, VALERIA (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:VALERIA
Middle Name:
Last Name:QUINTANILLA
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 DOVE ST
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-4102
Mailing Address - Country:US
Mailing Address - Phone:956-874-4574
Mailing Address - Fax:
Practice Address - Street 1:6422 S CAGE BLVD STE A
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6957
Practice Address - Country:US
Practice Address - Phone:956-783-7111
Practice Address - Fax:956-783-0911
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115601235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist