Provider Demographics
NPI:1013270842
Name:LOAIZA, MARIA DEL ROSARIO (MA, CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:MARIA DEL ROSARIO
Middle Name:
Last Name:LOAIZA
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:MS
Other - First Name:ROSARIO
Other - Middle Name:
Other - Last Name:LOAIZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC/SLP
Mailing Address - Street 1:61-45 98TH. STREET,
Mailing Address - Street 2:# 11M
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374
Mailing Address - Country:US
Mailing Address - Phone:718-760-3168
Mailing Address - Fax:
Practice Address - Street 1:61-45 98TH. STREET,
Practice Address - Street 2:# 11M
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1433
Practice Address - Country:US
Practice Address - Phone:718-760-3168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00416060-12355S0801X
NY004160-12355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant