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General NPI Number Information
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NPI Number | 1568105112
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Entity Type | Individual
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Provider Name | JULISSA ALEXANDRIA MARTELL BS ASST SLP
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Gender | Female
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Dates
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Enumeration Date | 04/20/2022
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Last Update Date | 04/26/2022
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Provider Practice Location Address
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Address Line | 505 ANGELITA DR STE 16
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City | WESLACO
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State | TX
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Zip | 78599-8694
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Country | US
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Telephone | 956-969-5777
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Fax | 956-969-5775
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Provider Business Mailing Address
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Address Line | 912 CLOSNER ST
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City | MERCEDES
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State | TX
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Zip | 78570-4505
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Country | US
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Telephone | 956-650-3336
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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 | 42007
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License Number State | TX
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