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General NPI Number Information
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NPI Number | 1629559356
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Entity Type | Individual
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Provider Name | YLSSE KRISTEL MALDONADO M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/21/2018
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Last Update Date | 08/21/2018
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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 | 210-568-3415
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Fax |
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Provider Business Mailing Address
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Address Line | 5415 DUKE FLD
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City | SAN ANTONIO
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State | TX
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Zip | 78227-4723
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Country | US
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Telephone | 956-285-2590
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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 | 109613
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License Number State | TX
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