Provider Demographics
NPI:1699253682
Name:ALEJANDRO-NINO, ILLIANA AIMEE (BS/SLP ASSISTANT)
Entity type:Individual
Prefix:
First Name:ILLIANA
Middle Name:AIMEE
Last Name:ALEJANDRO-NINO
Suffix:
Gender:F
Credentials:BS/SLP ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 E 8TH ST STE 7
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-4346
Mailing Address - Country:US
Mailing Address - Phone:956-447-3565
Mailing Address - Fax:956-447-8944
Practice Address - Street 1:910 E 8TH ST STE 7
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4346
Practice Address - Country:US
Practice Address - Phone:956-447-3565
Practice Address - Fax:956-447-8944
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX354672355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant