Provider Demographics
NPI:1821425240
Name:DRISCOLL, GUILDA ELIZABETH (SLP)
Entity Type:Individual
Prefix:
First Name:GUILDA
Middle Name:ELIZABETH
Last Name:DRISCOLL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:GUILDA
Other - Middle Name:E
Other - Last Name:TUTTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1714 POPPY PEAK ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2316
Mailing Address - Country:US
Mailing Address - Phone:956-250-4119
Mailing Address - Fax:
Practice Address - Street 1:4553 N LOOP 1604 E #1119
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249
Practice Address - Country:US
Practice Address - Phone:210-698-9844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107224235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist