Healthcare Provider Details
I. General information
NPI: 1770258691
Provider Name (Legal Business Name): CELESTE JUDITH TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/12/2021
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8001 S US HIGHWAY 75
SHERMAN TX
75090-5707
US
IV. Provider business mailing address
8001 S US HIGHWAY 75
SHERMAN TX
75090-5707
US
V. Phone/Fax
- Phone: 903-532-1400
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2355S0801X |
| Taxonomy | Speech-Language Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: