Basic Information
| Provider Information | |||||||||
| NPI: | 1871015974 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRIEDEL | ||||||||
| FirstName: | ASCELINA | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.A. CCC SLP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | GARZA | ||||||||
| OtherFirstName: | ASCELINA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8555 LAURENS LN APT 1106 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782186007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9567401065 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10839 QUARRY PARK | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782334681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102576260 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2017 | ||||||||
| LastUpdateDate: | 07/10/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 112405 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.