Provider Demographics
NPI:1841502234
Name:MALDONADO, YLEANA (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:YLEANA
Middle Name:
Last Name:MALDONADO
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 1:5210 WILDERNESS DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3833
Mailing Address - Country:US
Mailing Address - Phone:956-203-1767
Mailing Address - Fax:
Practice Address - Street 1:5210 WILDERNESS DR
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3833
Practice Address - Country:US
Practice Address - Phone:956-203-1767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105284235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist