Individual
MOMILANI DEANN CORONEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STASSISTANT
Contact information
Practice address
1613 WILDERNESS TRL, GRAND PRAIRIE, TX 75052-2028
(469) 990-6318
Mailing address
PO BOX 177545, IRVING, TX 75017-7545
(469) 990-6318
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
38921
TX
Other
Enumeration date
02/15/2018
Last updated
02/15/2018
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