Provider Demographics
NPI:1659847101
Name:ESCOBEDO, STEPHANIE DALILA
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DALILA
Last Name:ESCOBEDO
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 1:1351 E BARDIN RD STE 160
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-2137
Mailing Address - Country:US
Mailing Address - Phone:817-795-1291
Mailing Address - Fax:
Practice Address - Street 1:1351 E BARDIN RD # 169
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-2135
Practice Address - Country:US
Practice Address - Phone:817-795-1291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist