Basic Information
Provider Information
NPI: 1265834709
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VASQUEZ
FirstName: ARIANA
MiddleName:  
NamePrefix: MISS
NameSuffix:  
Credential: SLP ASSISTANT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 305 NE LOOP 820; BUSINESS TOWER 1
Address2: SUITE 200
City: HURST
State: TX
PostalCode: 76053
CountryCode: US
TelephoneNumber: 8172928787
FaxNumber: 8177896849
Practice Location
Address1: 9800 N LAMAR BLVD
Address2: SUITE 250
City: AUSTIN
State: TX
PostalCode: 787534160
CountryCode: US
TelephoneNumber: 5125279608
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/16/2014
LastUpdateDate: 09/16/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2355S0801X38251TXY Speech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant

No ID Information.


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