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General NPI Number Information
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NPI Number | 1679899561
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Entity Type | Organization
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Legal Business Name | L & J EVOLUTIONS, INC.
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Dates
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Enumeration Date | 04/16/2010
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Last Update Date | 03/03/2014
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Provider Practice Location Address
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Address Line | 900 SUMMIT CIR
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City | EDINBURG
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State | TX
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Zip | 78539-7055
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Country | US
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Telephone | 956-655-4443
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Fax | 956-289-1133
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Provider Business Mailing Address
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Address Line | 900 SUMMIT CIR
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City | EDINBURG
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State | TX
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Zip | 78539-7055
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Country | US
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Telephone | 956-655-4443
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Fax | 956-289-1133
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MRS. MELISSA Z. CABALLERO
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Credential | M.A. CCC-SLP
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Telephone | 956-655-4443
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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 | 18202
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 115282
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License Number State | TX
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