| Doctor Name: | MARY ANN TELLO |
| NPI Number: | 1013169010 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLPA |
| License Number: | 34653 |
| Business Practice Address: | 305 Ne Loop Businesstower 1 Suite 200 206 Hurst, TX - 76053 |
| Business Phone Number: | 8172928787 |
| Business Fax Number: | 8177896849 |
| Mailing Address: | 1505 Calle Del Norte, LAREDO |
| State: | TX |
| Postal Code: | 780416036 |
| Phone Number: | 9567448873 |
| Fax Number: | |
| NPI Enumeration Date: | 10/21/2008 |
| NPI Last Update Date: | 06/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | 34653 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |