Provider Demographics
NPI:1821573205
Name:SUAREZ, SANDRA YVETTE (BS SLP ASSISTANT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:YVETTE
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:BS SLP ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 E BUSTAMANTE ST STE G
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-5305
Mailing Address - Country:US
Mailing Address - Phone:955-718-2020
Mailing Address - Fax:956-718-2919
Practice Address - Street 1:1519 E BUSTAMANTE ST STE G
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5305
Practice Address - Country:US
Practice Address - Phone:956-718-2020
Practice Address - Fax:956-718-2919
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX379912355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant