Provider Demographics
NPI:1699063735
Name:DELAROSA, ELISA CAROLINA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ELISA
Middle Name:CAROLINA
Last Name:DELAROSA
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 1:225 SHIRLEY RAYE DR
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-0486
Mailing Address - Country:US
Mailing Address - Phone:830-734-3381
Mailing Address - Fax:
Practice Address - Street 1:1005 E 23RD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-0800
Practice Address - Country:US
Practice Address - Phone:866-784-2329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104052235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist