Provider Demographics
NPI:1144634379
Name:BAUTISTA, VALERIE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:BAUTISTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SANTANDER DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-7421
Mailing Address - Country:US
Mailing Address - Phone:956-753-6355
Mailing Address - Fax:956-753-6331
Practice Address - Street 1:3507 JAIME ZAPATA MEMORIAL HWY STE 1&2
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-4769
Practice Address - Country:US
Practice Address - Phone:956-753-6355
Practice Address - Fax:956-753-6331
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX364742355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant