Provider Demographics
NPI:1942647128
Name:TORRES, CELIMARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CELIMARIE
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 WILLOW CREEK DR STE 105
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76085-3652
Mailing Address - Country:US
Mailing Address - Phone:817-550-5058
Mailing Address - Fax:817-550-8177
Practice Address - Street 1:150 WILLOW CREEK DR STE 105
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76085-3652
Practice Address - Country:US
Practice Address - Phone:817-550-5058
Practice Address - Fax:817-550-8177
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107848235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist