Provider Demographics
NPI:1962608273
Name:FLORES, YOLANDA (MS-SLP, CCC)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:MS-SLP, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1363 PONY TRAIL PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6982
Mailing Address - Country:US
Mailing Address - Phone:915-860-1150
Mailing Address - Fax:
Practice Address - Street 1:1363 PONY TRAIL PL
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6982
Practice Address - Country:US
Practice Address - Phone:915-740-7773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-23
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1727235Z00000X
TX14991235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist