MEDICARE: XENIA HALLY GUERRA 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		TX

General Provider Information

NPI Number	:	1912320805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	XENIA HALLY GUERRA M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	2437 SENTRY PALM DR.
Second Line	:
City	:	RIO GRANDE CITY
State	:	TX
Zip	:	78582
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2437 SENTRY PALM DR.
Second Line	:
City	:	RIO GRANDE CITY
State	:	TX
Zip	:	78582
Country	:	US
Telephone Number	:	956-437-9102
Fax Number	:

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

Provider Enumeration Date	:	01/28/2014
Last Update Date	:	02/16/2016

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Directions to “ XENIA HALLY GUERRA M.S., CCC-SLP” Practice Location

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