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General NPI Number Information
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NPI Number | 1619613494
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Entity Type | Individual
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Provider Name | SAMANTHA ARIANA SAUCEDO CF-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/05/2022
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Last Update Date | 06/04/2022
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Provider Practice Location Address
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Address Line | 5100 JOHN D RYAN BLVD
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City | SAN ANTONIO
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State | TX
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Zip | 78245-3527
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Country | US
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Telephone | 210-677-8666
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Fax |
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Provider Business Mailing Address
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Address Line | 1902 W SUMMIT AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78201-4936
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Country | US
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Telephone | 210-882-9194
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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 | 119637
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License Number State | TX
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