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Individual
MRS. STEPHANIE COLLEEN CARRILLO
Active
Individual
MRS. STEPHANIE COLLEEN CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
100284
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134759100
FIRSTCARE PROVIDER NUMBER
TX
05
—
178080101
—
TX
01
—
8T3636
BLUECROSS BLUESHIELD
TX
Enumeration date
02/07/2007
Last updated
06/11/2014
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