Provider Demographics
NPI:1881844462
Name:CANO, CAROLINA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINA
Middle Name:
Last Name:CANO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:CAROLINA
Other - Middle Name:
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:710 SOUTH CAGE BOULEVARD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577
Mailing Address - Country:US
Mailing Address - Phone:956-783-8815
Mailing Address - Fax:956-783-8842
Practice Address - Street 1:710 SOUTH CAGE BOULEVARD
Practice Address - Street 2:SUITE B
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577
Practice Address - Country:US
Practice Address - Phone:956-783-8815
Practice Address - Fax:956-783-8842
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101967235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist