Provider Demographics
NPI:1568929842
Name:CERA, MARIA YVONNE (M S, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:YVONNE
Last Name:CERA
Suffix:
Gender:F
Credentials:M S, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 GRIJALVA DRIVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79927-5032
Mailing Address - Country:US
Mailing Address - Phone:915-203-8518
Mailing Address - Fax:
Practice Address - Street 1:731 GRIJALVA DRIVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79927-5032
Practice Address - Country:US
Practice Address - Phone:915-203-8518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17457235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist