Provider Demographics
NPI:1386283976
Name:MARTINEZ, CELISA ARIANA (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:CELISA
Middle Name:ARIANA
Last Name:MARTINEZ
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:PO BOX 314
Mailing Address - Street 2:
Mailing Address - City:ZAPATA
Mailing Address - State:TX
Mailing Address - Zip Code:78076-0314
Mailing Address - Country:US
Mailing Address - Phone:956-285-4662
Mailing Address - Fax:
Practice Address - Street 1:385 CERRITO DR
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076-4427
Practice Address - Country:US
Practice Address - Phone:956-285-4662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111929235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist