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General NPI Number Information
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NPI Number | 1750991196
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Entity Type | Individual
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Provider Name | CRISTAL LUNA SLP-INTERN
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Gender | Female
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Dates
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Enumeration Date | 07/31/2020
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 67 S HIGLEY RD STE 103-477
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City | GILBERT
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State | AZ
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Zip | 85296-1166
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Country | US
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Telephone | 832-484-3756
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Fax |
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Provider Business Mailing Address
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Address Line | 17116 HARPERS TRCE APT 1109
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City | CONROE
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State | TX
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Zip | 77385-1151
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Country | US
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Telephone | 281-740-4324
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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 | 124723
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License Number State | TX
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