Provider Demographics
NPI:1801692876
Name:REYES, VICTORIA ASHLEY
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ASHLEY
Last Name:REYES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4513 LOMA DEL REY CIR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79934-4100
Mailing Address - Country:US
Mailing Address - Phone:915-543-1580
Mailing Address - Fax:
Practice Address - Street 1:6310 N MESA ST STE C2
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4555
Practice Address - Country:US
Practice Address - Phone:915-222-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44337235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist