Provider Demographics
NPI:1285958066
Name:SOTO, JULIA A (ST)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:A
Last Name:SOTO
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 N MALINCHE AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043-3354
Mailing Address - Country:US
Mailing Address - Phone:956-722-2431
Mailing Address - Fax:956-568-2060
Practice Address - Street 1:1220 N MALINCHE AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-3354
Practice Address - Country:US
Practice Address - Phone:956-722-2431
Practice Address - Fax:956-568-2060
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101216235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist