Provider Demographics
NPI:1538057302
Name:MASCORRO, KARLENY (SLP CFY)
Entity type:Individual
Prefix:
First Name:KARLENY
Middle Name:
Last Name:MASCORRO
Suffix:
Gender:F
Credentials:SLP CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E BRAVO BLVD
Mailing Address - Street 2:
Mailing Address - City:ROMA
Mailing Address - State:TX
Mailing Address - Zip Code:78584-5741
Mailing Address - Country:US
Mailing Address - Phone:956-849-1818
Mailing Address - Fax:956-849-1822
Practice Address - Street 1:700 E BRAVO BLVD
Practice Address - Street 2:
Practice Address - City:ROMA
Practice Address - State:TX
Practice Address - Zip Code:78584-5741
Practice Address - Country:US
Practice Address - Phone:956-849-1818
Practice Address - Fax:956-849-1822
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123701390200000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program