Healthcare Provider Details

I. General information

NPI: 1093638819
Provider Name (Legal Business Name): ISABELLA TERESA ANGUIANO QUINTANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2251 S OTONDO DR
YUMA AZ
85365-8843
US

IV. Provider business mailing address

450 W 6TH ST
YUMA AZ
85364-2973
US

V. Phone/Fax

Practice location:
  • Phone: 928-550-1732
  • Fax:
Mailing address:
  • Phone: 928-550-1732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA17551
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: