Provider Demographics
NPI:1972295541
Name:PEREZ, ANA MARIELLA (MS, SLP-CFY)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:MARIELLA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MS, SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 E CURRY RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-5683
Mailing Address - Country:US
Mailing Address - Phone:956-957-7537
Mailing Address - Fax:956-436-5050
Practice Address - Street 1:8030 N FM 1015 STE C
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-4809
Practice Address - Country:US
Practice Address - Phone:956-957-7537
Practice Address - Fax:956-436-5050
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120778235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist