Provider Demographics
NPI:1295112795
Name:REYES, VICTORIA (MS SLP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:D6 CALLE LOS PICACHOS
Mailing Address - Street 2:COLINAS METROPOLITANAS
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5216
Mailing Address - Country:US
Mailing Address - Phone:787-346-2069
Mailing Address - Fax:
Practice Address - Street 1:D6 CALLE LOS PICACHOS
Practice Address - Street 2:COLINAS METROPOLITANAS
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5216
Practice Address - Country:US
Practice Address - Phone:787-346-2069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3054235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist