Provider Demographics
NPI:1558661645
Name:AVALOS ROSALES, MARIA CRISTINA (SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:CRISTINA
Last Name:AVALOS ROSALES
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 1:3111 32ND ST
Mailing Address - Street 2:APT. 19
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11106-2550
Mailing Address - Country:US
Mailing Address - Phone:191-749-6979
Mailing Address - Fax:
Practice Address - Street 1:116 W 32ND ST
Practice Address - Street 2:8 FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3212
Practice Address - Country:US
Practice Address - Phone:212-564-2350
Practice Address - Fax:718-597-7277
Is Sole Proprietor?:No
Enumeration Date:2010-10-24
Last Update Date:2017-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018012-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist