Provider Demographics
NPI:1104334614
Name:VEGA, DAISY ACEVEDO (BA SLP ASSISTANT)
Entity type:Individual
Prefix:MS
First Name:DAISY
Middle Name:ACEVEDO
Last Name:VEGA
Suffix:
Gender:F
Credentials:BA SLP ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:907 N PRUETT ST APT 34
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-4559
Mailing Address - Country:US
Mailing Address - Phone:281-683-9402
Mailing Address - Fax:
Practice Address - Street 1:907 N PRUET ST APT 34
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-7752
Practice Address - Country:US
Practice Address - Phone:281-683-9402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX402292355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant