Provider Demographics
NPI:1699059915
Name:CLOSNER, RAQUEL (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:
Last Name:CLOSNER
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 92
Mailing Address - Street 2:
Mailing Address - City:RAYMONDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78580-0092
Mailing Address - Country:US
Mailing Address - Phone:956-689-5301
Mailing Address - Fax:956-689-2004
Practice Address - Street 1:100 N US HIGHWAY 77
Practice Address - Street 2:SUITE I
Practice Address - City:RAYMONDVILLE
Practice Address - State:TX
Practice Address - Zip Code:78580-4000
Practice Address - Country:US
Practice Address - Phone:956-689-5301
Practice Address - Fax:956-689-2004
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105969235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX363617701Medicaid