Provider Demographics
NPI:1841831542
Name:ORTEGA, MAYRA GIZELA (SLPA)
Entity type:Individual
Prefix:MRS
First Name:MAYRA
Middle Name:GIZELA
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10711 HIDDEN LAKE LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-8809
Mailing Address - Country:US
Mailing Address - Phone:832-618-0224
Mailing Address - Fax:
Practice Address - Street 1:10711 HIDDEN LAKE LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-8809
Practice Address - Country:US
Practice Address - Phone:832-618-0224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX384742355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant