Provider Demographics
NPI:1538640198
Name:SUAREZ, JESSICA (BS ASSISTANT SLP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:BS ASSISTANT SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N 43RD ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-8131
Mailing Address - Country:US
Mailing Address - Phone:956-739-4929
Mailing Address - Fax:
Practice Address - Street 1:6400 S CAGE BLVD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6870
Practice Address - Country:US
Practice Address - Phone:956-783-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2019-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX400342355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant