Doctor Name: | CONSUELO MONICA DE AVILA |
NPI Number: | 1801912977 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 24778 |
Business Practice Address: | 2801 Sw 73rd Way Apt 1711 Davie, FL - 333141019 |
Business Phone Number: | 9545297194 |
Business Fax Number: | |
Mailing Address: | 2801 Sw 73rd Way Apt 1711, DAVIE |
State: | FL |
Postal Code: | 333141019 |
Phone Number: | 9545297194 |
Fax Number: | |
NPI Enumeration Date: | 03/21/2007 |
NPI Last Update Date: | 01/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 24778 |
Healthcare Provider Taxonomy: (Secondary) | N |
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 |