Provider Demographics
NPI:1508342262
Name:RESENDEZ, ARIADNA DE JEHOVA (BS SLP-A)
Entity Type:Individual
Prefix:
First Name:ARIADNA
Middle Name:DE JEHOVA
Last Name:RESENDEZ
Suffix:
Gender:F
Credentials:BS SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 PAREDES LINE RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-3693
Mailing Address - Country:US
Mailing Address - Phone:956-621-0277
Mailing Address - Fax:
Practice Address - Street 1:620 PAREDES LINE RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-3693
Practice Address - Country:US
Practice Address - Phone:956-621-0277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX373222355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant