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General NPI Number Information
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NPI Number | 1376861179
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Entity Type | Individual
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Provider Name | LISA LONGORIA MA, CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 05/04/2010
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 1060 ELBEL RD
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City | SCHERTZ
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State | TX
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Zip | 78154-2037
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Country | US
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Telephone | 210-945-6475
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Fax |
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Provider Business Mailing Address
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Address Line | 15357 MILLER RD
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City | SAINT HEDWIG
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State | TX
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Zip | 78152-9807
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Country | US
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Telephone |
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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 | 18804
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License Number State | TX
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