Individual
MS. DENISE DIETERT CARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCCSLP
Contact information
Practice address
411 SW 24TH STREET, SAN ANTONIO, TX 78207-4689
(219) 434-6711
(210) 434-9360
Mailing address
411 SW 24TH STREET, HARRY JERSIG CENTER OUR LADY OF THE LAKE UNIVERSITY, SAN ANTONIO, TX 78207-4689
(219) 434-6711
(210) 434-9360
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11598
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
87576T
BCBS TX
TX
Enumeration date
04/18/2007
Last updated
07/08/2007
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