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Individual
MS. MARY RUTH FERNANDEZ
Active
Individual
MS. MARY RUTH FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCCSLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12916
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003747501
—
TX
01
—
87863T
BCBS TX
TX
Enumeration date
04/18/2007
Last updated
07/08/2007
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