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General NPI Number Information
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NPI Number | 1366529232
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Entity Type | Individual
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Provider Name | MAURICE KRISTINA CACERES CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 11/16/2011
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Provider Practice Location Address
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Address Line | 1210 W EXPY 83 SUITE 7
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City | PHARR
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State | TX
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Zip | 78577-6516
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Country | US
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Telephone | 956-783-9000
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Fax | 956-783-9131
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Provider Business Mailing Address
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Address Line | PO BOX 3008
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City | EDINBURG
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State | TX
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Zip | 78540-3008
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Country | US
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Telephone | 956-289-6355
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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 | 105591
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License Number State | TX
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