Provider Demographics
NPI:1699804328
Name:HERNANDEZ-ARELLANO, VIVIAN SOSA (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:SOSA
Last Name:HERNANDEZ-ARELLANO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:VIVIAN
Other - Middle Name:S
Other - Last Name:MATLACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2700 YONKERS ST.
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072
Mailing Address - Country:US
Mailing Address - Phone:806-293-2636
Mailing Address - Fax:806-213-1102
Practice Address - Street 1:2700 YONKERS ST.
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072
Practice Address - Country:US
Practice Address - Phone:806-293-2636
Practice Address - Fax:806-213-1102
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3207235Z00000X
NM114228235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist