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General NPI Number Information
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NPI Number | 1366161606
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Entity Type | Individual
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Provider Name | ISIAMARA AVILES MS THL
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Gender | Female
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 20 CALLE RUFINA
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City | GUAYANILLA
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State | PR
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Zip | 00656-1809
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Country | US
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Telephone | 939-928-9036
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 561447
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City | GUAYANILLA
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State | PR
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Zip | 00656-3447
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Country | US
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Telephone | 787-974-2583
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 6090
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License Number State | PR
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