Provider Demographics
NPI:1790220887
Name:SANCHEZ, MAYRA LETICIA (SLP)
Entity Type:Individual
Prefix:
First Name:MAYRA
Middle Name:LETICIA
Last Name:SANCHEZ
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 1:9140 109TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2235
Mailing Address - Country:US
Mailing Address - Phone:646-509-9383
Mailing Address - Fax:
Practice Address - Street 1:9140 109TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2235
Practice Address - Country:US
Practice Address - Phone:646-509-9383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-27
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist