Provider Demographics
NPI:1871015974
Name:FRIEDEL, ASCELINA (MA CCC SLP)
Entity Type:Individual
Prefix:
First Name:ASCELINA
Middle Name:
Last Name:FRIEDEL
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:ASCELINA
Other - Middle Name:
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8555 LAURENS LN APT 1106
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-6007
Mailing Address - Country:US
Mailing Address - Phone:956-740-1065
Mailing Address - Fax:
Practice Address - Street 1:10839 QUARRY PARK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-4681
Practice Address - Country:US
Practice Address - Phone:210-257-6260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112405235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist