Provider Demographics
NPI:1306526447
Name:GONZALEZ, ROXANNE LEIGH (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:LEIGH
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 FLEET ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-2854
Mailing Address - Country:US
Mailing Address - Phone:956-545-2462
Mailing Address - Fax:
Practice Address - Street 1:1725 BOCA CHICA BLVD APT B
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8173
Practice Address - Country:US
Practice Address - Phone:956-621-0277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121051235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist