Provider Demographics
NPI:1285327155
Name:SIMENTAL-LOPEZ, PRISCILLA ESMERALDA (SLP- ASSISTANT)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:ESMERALDA
Last Name:SIMENTAL-LOPEZ
Suffix:
Gender:F
Credentials:SLP- ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 IDAHO AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-2026
Mailing Address - Country:US
Mailing Address - Phone:214-641-7796
Mailing Address - Fax:
Practice Address - Street 1:1112 E COPELAND RD STE 300
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-4910
Practice Address - Country:US
Practice Address - Phone:214-641-7796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX431032355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant