Provider Demographics
NPI:1366529232
Name:CACERES, MAURICE KRISTINA (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MAURICE
Middle Name:KRISTINA
Last Name:CACERES
Suffix:
Gender:F
Credentials: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:PO BOX 3008
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78540-3008
Mailing Address - Country:US
Mailing Address - Phone:956-289-6355
Mailing Address - Fax:
Practice Address - Street 1:1210 W EXPY 83
Practice Address - Street 2:SUITE 7
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6516
Practice Address - Country:US
Practice Address - Phone:956-783-9000
Practice Address - Fax:956-783-9131
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105591235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist