Individual
IVANNA DE LA FUENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4430 E 14TH ST UNIT E, BROWNSVILLE, TX 78521-3364
(956) 542-6296
Mailing address
223 E ELIZABETH ST, BROWNSVILLE, TX 78520-5457
(956) 545-5379
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
—
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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