Provider Demographics
NPI:1730609934
Name:MONSERRATE, MARIA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MONSERRATE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W MAIN ST STE 210
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-4224
Mailing Address - Country:US
Mailing Address - Phone:972-638-7286
Mailing Address - Fax:972-499-1334
Practice Address - Street 1:120 W MAIN ST STE 210
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-4224
Practice Address - Country:US
Practice Address - Phone:972-638-7286
Practice Address - Fax:972-499-1334
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112526235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112526OtherSPEECH LANGUAGE PATHOLOGIST LICENSE