Provider Demographics
NPI:1730310350
Name:RIVERA, CATALINA (BS ASST-SLP)
Entity Type:Individual
Prefix:
First Name:CATALINA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:BS ASST-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 S CYNTHIA ST
Mailing Address - Street 2:STE A
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1278
Mailing Address - Country:US
Mailing Address - Phone:956-630-6300
Mailing Address - Fax:956-630-3443
Practice Address - Street 1:2001 S CYNTHIA ST STE A
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1278
Practice Address - Country:US
Practice Address - Phone:956-630-6300
Practice Address - Fax:956-630-3443
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX349512355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167033301Medicaid