Provider Demographics
NPI:1922721729
Name:AVILA, GENEVIE (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:GENEVIE
Middle Name:
Last Name:AVILA
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 COUNTY ROAD 3704B
Mailing Address - Street 2:
Mailing Address - City:SPLENDORA
Mailing Address - State:TX
Mailing Address - Zip Code:77372-4199
Mailing Address - Country:US
Mailing Address - Phone:832-643-9132
Mailing Address - Fax:
Practice Address - Street 1:7499 COUNTY RD 3540
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327
Practice Address - Country:US
Practice Address - Phone:346-799-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX199224235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist