Provider Demographics
NPI:1295968964
Name:LOZANO, YVETTE MARIE (MA, CCC/SLP)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:MARIE
Last Name:LOZANO
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 SW 24TH ST.
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-4689
Mailing Address - Country:US
Mailing Address - Phone:210-434-6711
Mailing Address - Fax:219-434-9360
Practice Address - Street 1:411 SW 24TH ST.
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-4689
Practice Address - Country:US
Practice Address - Phone:210-434-6711
Practice Address - Fax:219-434-9360
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16215235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist