Provider Demographics
NPI:1487415832
Name:AMPONSAH, LILIANNA CHAPA (MS)
Entity type:Individual
Prefix:
First Name:LILIANNA
Middle Name:CHAPA
Last Name:AMPONSAH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:LILIANNA
Other - Middle Name:
Other - Last Name:CHAPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 VILLAGE CREEK PKWY APT 1210
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-3472
Mailing Address - Country:US
Mailing Address - Phone:956-373-7428
Mailing Address - Fax:
Practice Address - Street 1:4365 S HULEN ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-4917
Practice Address - Country:US
Practice Address - Phone:817-238-3023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121521235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist