Provider Demographics
NPI:1588239115
Name:CUEVAS CARDEL, GLIEDMAR (SLPA)
Entity Type:Individual
Prefix:
First Name:GLIEDMAR
Middle Name:
Last Name:CUEVAS CARDEL
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 1:6524 STONEY VIEW LN UNIT 6
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-6430
Mailing Address - Country:US
Mailing Address - Phone:787-503-8286
Mailing Address - Fax:
Practice Address - Street 1:15451 SAN FERNANDO MISSION BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1396
Practice Address - Country:US
Practice Address - Phone:787-365-1115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36042355S0801X
FLSI48622355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant