Doctor Name: | MONICA D PENA |
NPI Number: | 1073748984 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP-CCC |
License Number: | 24591 |
Business Practice Address: | 700 E Bravo Blvd Ste C Roma, TX - 785845668 |
Business Phone Number: | 9565192500 |
Business Fax Number: | |
Mailing Address: | Po Box 992, ROMA |
State: | TX |
Postal Code: | 785840992 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/20/2009 |
NPI Last Update Date: | 05/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 24591 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |