Provider Demographics
NPI:1841779089
Name:SANDOVAL, MONICA G (SLPA)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:G
Last Name:SANDOVAL
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E GRIFFIN PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3360
Mailing Address - Country:US
Mailing Address - Phone:956-424-1292
Mailing Address - Fax:
Practice Address - Street 1:1601 E GRIFFIN PKWY STE C
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3360
Practice Address - Country:US
Practice Address - Phone:956-424-1292
Practice Address - Fax:956-424-3192
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341992355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant