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General NPI Number Information
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NPI Number | 1568129070
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Entity Type | Individual
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Provider Name | MARTINA GARCELLA ISAAC M.A. CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 328 NEWSOM RD
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City | MESQUITE
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State | TX
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Zip | 75149-5056
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Country | US
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Telephone | 337-540-8608
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Fax |
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Provider Business Mailing Address
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Address Line | 500 W CARTWRIGHT RD APT 1222
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City | BALCH SPRINGS
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State | TX
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Zip | 75180-4846
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Country | US
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Telephone | 337-540-8608
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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 |
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License Number State |
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