Provider Demographics
NPI:1598237323
Name:GOMEZ, DELIA LORENA (CFY-SLP)
Entity Type:Individual
Prefix:
First Name:DELIA
Middle Name:LORENA
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:CFY-SLP
Other - Prefix:
Other - First Name:DELIA
Other - Middle Name:LORENA
Other - Last Name:GALLEGOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1512 N ZARAGOZA RD STE C1
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-8903
Mailing Address - Country:US
Mailing Address - Phone:915-855-0601
Mailing Address - Fax:915-855-0751
Practice Address - Street 1:1512 N ZARAGOZA RD STE C1
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-8903
Practice Address - Country:US
Practice Address - Phone:915-855-0601
Practice Address - Fax:915-855-0751
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115230235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty