Provider Demographics
NPI:1700018017
Name:APONTE SANTIAGO, MARISOL (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MARISOL
Middle Name:
Last Name:APONTE SANTIAGO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13522 BELTWAY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-1703
Mailing Address - Country:US
Mailing Address - Phone:178-762-8424
Mailing Address - Fax:
Practice Address - Street 1:13522 BELTWAY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-1703
Practice Address - Country:US
Practice Address - Phone:178-762-8424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR876235Z00000X
TX106407235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist