Provider Demographics
NPI:1558735928
Name:GUEVARA, CHRISTINA LOPEZ (CCC/SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LOPEZ
Last Name:GUEVARA
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-5205
Mailing Address - Country:US
Mailing Address - Phone:210-241-5792
Mailing Address - Fax:
Practice Address - Street 1:137 N HIGH ST
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-5205
Practice Address - Country:US
Practice Address - Phone:210-241-5792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-21
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104549235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist