Provider Demographics
NPI:1568956902
Name:MENDOZA, MARIA CRYSTAL (SLPA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CRYSTAL
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 68TH AVE UNIT E
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-8077
Mailing Address - Country:US
Mailing Address - Phone:970-576-4277
Mailing Address - Fax:
Practice Address - Street 1:1901 56TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2950
Practice Address - Country:US
Practice Address - Phone:970-576-4277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant