Provider Demographics
NPI:1598476426
Name:NAVAL, ELOISA JERIELYN MANALO
Entity Type:Individual
Prefix:
First Name:ELOISA JERIELYN
Middle Name:MANALO
Last Name:NAVAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 W SAN RICARDO BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-4636
Mailing Address - Country:US
Mailing Address - Phone:520-490-3044
Mailing Address - Fax:
Practice Address - Street 1:1443 W SAN RICARDO BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-4636
Practice Address - Country:US
Practice Address - Phone:520-490-3044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA142352355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty