| Doctor Name: | AUDREY RENEE ALBA |
| NPI Number: | 1306101258 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 36872 |
| Business Practice Address: | 6601 Montana Ave Suite G El Paso, TX - 799252155 |
| Business Phone Number: | 9158387604 |
| Business Fax Number: | 8177896849 |
| Mailing Address: | 5316 Trail Lake Dr, FORT WORTH |
| State: | TX |
| Postal Code: | 761331931 |
| Phone Number: | 8172928787 |
| Fax Number: | 8177896849 |
| NPI Enumeration Date: | 07/06/2012 |
| NPI Last Update Date: | 07/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 36872 |
| 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 |