MEDICARE: MRS. VALERIE H VIVAR M.S.CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	24843	TX

General Provider Information

NPI Number	:	1477676120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VALERIE H VIVAR M.S.CCC-SLP

Provider Business Mailing Address
First Line	:	3304 RUNNING DEER DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-2217
Country	:	US
Telephone Number	:	915-727-0917
Fax Number	:

Provider Business Practice Location Address
First Line	:	3304 RUNNING DEER DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-2217
Country	:	US
Telephone Number	:	915-727-0917
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	07/08/2007

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