Provider Demographics
NPI:1629232202
Name:ESPARZA, YLIANA O (MACCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:YLIANA
Middle Name:O
Last Name:ESPARZA
Suffix:
Gender:F
Credentials:MACCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 BEN HOGAN AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-3113
Mailing Address - Country:US
Mailing Address - Phone:956-624-4017
Mailing Address - Fax:956-618-4787
Practice Address - Street 1:208 BEN HOGAN AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-3113
Practice Address - Country:US
Practice Address - Phone:956-624-4017
Practice Address - Fax:956-618-4787
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19045235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist