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General NPI Number Information
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NPI Number | 1043455629
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Entity Type | Individual
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Provider Name | AUDRA GAIL SOTO M.S.,CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 03/19/2020
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Provider Practice Location Address
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Address Line | 3804 S JACKSON RD # 1
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City | EDINBURG
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State | TX
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Zip | 78539-6681
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Country | US
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Telephone | 956-296-3001
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Fax | 956-296-3000
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Provider Business Mailing Address
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Address Line | 6002 NACAHUITA LN
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City | HARLINGEN
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State | TX
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Zip | 78552-1908
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Country | US
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Telephone | 956-647-8762
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 102914
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License Number State | TX
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