Individual
MRS. BETHANY ANN LAQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
7035 SAN PEDRO AVE, SAN ANTONIO, TX 78216
(956) 377-8000
Mailing address
4311 CHARIOT, VON ORMY, TX 78073-5349
(210) 753-9366
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
118044
TX
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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