Provider Demographics
NPI:1942636899
Name:FUENTES, CECILIA ANN (BA SLP-A)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:ANN
Last Name:FUENTES
Suffix:
Gender:F
Credentials:BA SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 HAMMERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-1913
Mailing Address - Country:US
Mailing Address - Phone:713-935-9088
Mailing Address - Fax:
Practice Address - Street 1:11001 HAMMERLY BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-1913
Practice Address - Country:US
Practice Address - Phone:713-935-9088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX378772355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant