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NPI Code Detail

MEDICARE: DANIELA QUINTERO M.A. CCC-SLP

MEDICARE: DANIELA QUINTERO M.A. CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist109034TX

General Provider Information

NPI Number : 1093196735
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELA QUINTERO M.A. CCC-SLP
Provider Business Mailing Address
First Line : 5905 3RD ST APT 1302
Second Line :
City : LUBBOCK
State : TX
Zip : 79416-1737
Country : US
Telephone Number : 806-626-1234
Fax Number :
Provider Business Practice Location Address
First Line : 3501 S LOOP 289
Second Line :
City : LUBBOCK
State : TX
Zip : 79423-1139
Country : US
Telephone Number : 806-796-1774
Fax Number : 806-796-1717
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2015
Last Update Date : 06/17/2015

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Directions to “ DANIELA QUINTERO M.A. CCC-SLP” Practice Location

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