Provider Demographics
NPI:1134443476
Name:ALCALA, GINA MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:GINA
Middle Name:MARIE
Last Name:ALCALA
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 1:2901 CENTRAL BLVD
Mailing Address - Street 2:APT 607
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8903
Mailing Address - Country:US
Mailing Address - Phone:361-446-1806
Mailing Address - Fax:
Practice Address - Street 1:2901 CENTRAL BLVD
Practice Address - Street 2:APT 607
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8903
Practice Address - Country:US
Practice Address - Phone:361-446-1806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104827235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist