Provider Demographics
NPI:1679050447
Name:EURESTI, DAVINA DENISE
Entity type:Individual
Prefix:
First Name:DAVINA
Middle Name:DENISE
Last Name:EURESTI
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:PO BOX 267
Mailing Address - Street 2:
Mailing Address - City:OLMITO
Mailing Address - State:TX
Mailing Address - Zip Code:78575-0267
Mailing Address - Country:US
Mailing Address - Phone:956-465-3112
Mailing Address - Fax:
Practice Address - Street 1:613 W SESAME DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7930
Practice Address - Country:US
Practice Address - Phone:956-399-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant