Provider Demographics
NPI:1699954826
Name:ALEGRIA, IDA MICHELLE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:IDA
Middle Name:MICHELLE
Last Name:ALEGRIA
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 1:1206 E HAWK AVE
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-4328
Mailing Address - Country:US
Mailing Address - Phone:956-534-1621
Mailing Address - Fax:
Practice Address - Street 1:216 E EXPRESSWAY 83
Practice Address - Street 2:SUITE J
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6517
Practice Address - Country:US
Practice Address - Phone:956-534-1621
Practice Address - Fax:956-781-9580
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103479235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist