Doctor Name: | MRS. MARY ELLEN CAMPOSANO |
NPI Number: | 1134574759 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP, CAED |
License Number: | 12089349 |
Business Practice Address: | 1101 N Campbell St El Paso, TX - 799024238 |
Business Phone Number: | 9157478220 |
Business Fax Number: | |
Mailing Address: | 10017 Chezelle Dr, EL PASO |
State: | TX |
Postal Code: | 799255409 |
Phone Number: | 9153096576 |
Fax Number: | |
NPI Enumeration Date: | 05/02/2016 |
NPI Last Update Date: | 05/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12089349 |
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 |