Provider Demographics
NPI:1013770601
Name:AGUIRRE, ELSA DOREEN (SLPA)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:DOREEN
Last Name:AGUIRRE
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10213 E 39TH PL
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-5524
Mailing Address - Country:US
Mailing Address - Phone:928-257-7750
Mailing Address - Fax:
Practice Address - Street 1:3150 S AVENUE A
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7928
Practice Address - Country:US
Practice Address - Phone:928-502-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA149612355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant