Provider Demographics
NPI:1740895556
Name:ESPINOZA, ALICIA (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:ESPINOZA
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 1:1977 DAWN DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-3323
Mailing Address - Country:US
Mailing Address - Phone:321-506-0059
Mailing Address - Fax:
Practice Address - Street 1:6400 UPTOWN BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4202
Practice Address - Country:US
Practice Address - Phone:505-880-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR202459235Z00000X
NMSAH-2024-0373235Z00000X
FLSZ9789235Z00000X
FL19191235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist