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NPI Code Detail

MEDICARE: CHRISTINA DIAZ ROBERTSON M.S. CCC-SLP

MEDICARE: CHRISTINA DIAZ ROBERTSON 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
1235Z00000XSpeech-Language Pathologist24968TX

General Provider Information

NPI Number : 1679867279
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA DIAZ ROBERTSON M.S. CCC-SLP
Provider Business Mailing Address
First Line : 14260 TIERRA YAMILA LN
Second Line :
City : EL PASO
State : TX
Zip : 79938-5322
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6028 SURETY DR STE 101
Second Line :
City : EL PASO
State : TX
Zip : 79905-2024
Country : US
Telephone Number : 915-771-8523
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2011
Last Update Date : 06/01/2011

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Directions to “ CHRISTINA DIAZ ROBERTSON M.S. CCC-SLP” Practice Location

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