Provider Demographics
NPI:1851147250
Name:GONZALEZ, CELINA YVETTE (BS SLP-ASSISTANT)
Entity type:Individual
Prefix:
First Name:CELINA
Middle Name:YVETTE
Last Name:GONZALEZ
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:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:ROMA
Mailing Address - State:TX
Mailing Address - Zip Code:78584-0061
Mailing Address - Country:US
Mailing Address - Phone:956-847-6637
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 61
Practice Address - Street 2:
Practice Address - City:ROMA
Practice Address - State:TX
Practice Address - Zip Code:78584-0061
Practice Address - Country:US
Practice Address - Phone:956-847-6637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38733235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist