Individual
ANITRIA M GAMBOA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2653 EASY ST., EDINBURG, TX 78539-7861
(956) 225-5816
Mailing address
2653 EASY ST, EDINBURG, TX 78539-7385
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
102453
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102453
TX STATE BOARD OF SLP
TX
Enumeration date
04/05/2007
Last updated
10/16/2008
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