Provider Demographics
NPI:1780768184
Name:CEDILLO, ROSARIO S (MACCSLP)
Entity type:Individual
Prefix:
First Name:ROSARIO
Middle Name:S
Last Name:CEDILLO
Suffix:
Gender:F
Credentials:MACCSLP
Other - Prefix:
Other - First Name:ROSIE
Other - Middle Name:
Other - Last Name:CEDILLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MACCSLP
Mailing Address - Street 1:5309 N MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2252
Mailing Address - Country:US
Mailing Address - Phone:956-664-1819
Mailing Address - Fax:956-973-8972
Practice Address - Street 1:5309 N MCCOLL RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2252
Practice Address - Country:US
Practice Address - Phone:956-664-1819
Practice Address - Fax:956-973-8972
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17024235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172858601Medicaid
TX676592OtherMEDICARE GROUP NUMBER