Healthcare Provider Details
I. General information
NPI: 1821908856
Provider Name (Legal Business Name): MARIA FERNANDA QUINTERO SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10141 E 39TH PL
YUMA AZ
85365-5518
US
IV. Provider business mailing address
10141 E 39TH PL
YUMA AZ
85365-5518
US
V. Phone/Fax
- Phone: 928-550-1202
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2355S0801X |
| Taxonomy | Speech-Language Assistant |
| License Number | SLPA16435 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: