Provider Demographics
NPI:1841834660
Name:GUILLEN, ANSHELA FRANCINNE (SLP)
Entity type:Individual
Prefix:
First Name:ANSHELA
Middle Name:FRANCINNE
Last Name:GUILLEN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10140 SW 15TH PL
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7401
Mailing Address - Country:US
Mailing Address - Phone:718-873-3913
Mailing Address - Fax:
Practice Address - Street 1:1897 NE 146TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-1423
Practice Address - Country:US
Practice Address - Phone:305-949-4191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA22012235Z00000X
CASP36540235Z00000X
AZSLP14888235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist