Provider Demographics
NPI:1053072363
Name:CHEHEDEH, LAILANI (MS- SLP)
Entity type:Individual
Prefix:
First Name:LAILANI
Middle Name:
Last Name:CHEHEDEH
Suffix:
Gender:F
Credentials:MS- SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8713 HOPEWELL DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-2609
Mailing Address - Country:US
Mailing Address - Phone:915-781-6985
Mailing Address - Fax:
Practice Address - Street 1:12440 ROJAS DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79928-5261
Practice Address - Country:US
Practice Address - Phone:915-851-7181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-08
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122480235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty