Provider Demographics
NPI:1124286315
Name:PANEQUE, TOYA LASHAWN (MS/CCC/SLP)
Entity type:Individual
Prefix:
First Name:TOYA
Middle Name:LASHAWN
Last Name:PANEQUE
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 1:4143 LAKE BAYSHORE DR UNIT C508
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-9176
Mailing Address - Country:US
Mailing Address - Phone:941-962-0220
Mailing Address - Fax:
Practice Address - Street 1:4143 LAKE BAYSHORE DR # C508
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-9176
Practice Address - Country:US
Practice Address - Phone:941-962-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-25
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8186235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist