Provider Demographics
NPI:1477954998
Name:DELAFUENTE, LUCERO (SLP)
Entity Type:Individual
Prefix:
First Name:LUCERO
Middle Name:
Last Name:DELAFUENTE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4609 SAN DARIO AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-5773
Mailing Address - Country:US
Mailing Address - Phone:956-723-6600
Mailing Address - Fax:956-723-6614
Practice Address - Street 1:3507 JAIME ZAPATA MEMORIAL HWY STE 7
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-4769
Practice Address - Country:US
Practice Address - Phone:956-753-5600
Practice Address - Fax:956-753-5602
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110027235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist