| Doctor Name: | MRS. MARITESS ESTREVILLO DIMALIWAT |
| NPI Number: | 1841324894 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | SLPL5347 |
| Business Practice Address: | 5893 Mule Deer Way Pinetop, AZ - 859358665 |
| Business Phone Number: | 9283384138 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1973, PINETOP |
| State: | AZ |
| Postal Code: | 859351973 |
| Phone Number: | 9174532362 |
| Fax Number: | |
| NPI Enumeration Date: | 03/14/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLPL5347 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| 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 |