Provider Demographics
NPI:1992930341
Name:QUINONES SUAREZ, WANDALY (SPEECH LANGUAGE ASSI)
Entity type:Individual
Prefix:MS
First Name:WANDALY
Middle Name:
Last Name:QUINONES SUAREZ
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE ASSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UR. VILLA GRILLASCA 906 VIRGILIO BIAGGI
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:787-840-7928
Mailing Address - Fax:787-290-2475
Practice Address - Street 1:906 VIRGILIO BIAGGI
Practice Address - Street 2:UR. VILLA GRILLASCA
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-840-7928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11302355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant