Individual
BAHOLA PUENTES POLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC/SLP
Contact information
Practice address
2431 ARIZONA AVE, EL PASO, TX 79930-1008
(915) 544-8381
Mailing address
2431 ARIZONA AVE, EL PASO, TX 79930-1008
(915) 544-8381
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
101174
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173039201
—
TX
Enumeration date
04/02/2007
Last updated
03/01/2012
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