Provider Demographics
NPI:1740416106
Name:AVILA, YANELI (SLP)
Entity Type:Individual
Prefix:MRS
First Name:YANELI
Middle Name:
Last Name:AVILA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WEST AVE
Mailing Address - Street 2:APT. #2
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-4621
Mailing Address - Country:US
Mailing Address - Phone:203-977-4675
Mailing Address - Fax:
Practice Address - Street 1:45 WEST AVE
Practice Address - Street 2:APT. #2
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-4621
Practice Address - Country:US
Practice Address - Phone:203-569-0197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist