Provider Demographics
NPI:1073356523
Name:ESPINOSA, RUTHIE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:RUTHIE
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18022 LANGFORD LN
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-8174
Mailing Address - Country:US
Mailing Address - Phone:469-450-0262
Mailing Address - Fax:
Practice Address - Street 1:5250 MEDICAL DR STE 5001
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-5001
Practice Address - Country:US
Practice Address - Phone:469-450-0262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19595235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist