Provider Demographics
NPI:1679202915
Name:MATOS, ARA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ARA
Middle Name:
Last Name:MATOS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 TWILIGHT RD
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5528
Mailing Address - Country:US
Mailing Address - Phone:512-769-4328
Mailing Address - Fax:
Practice Address - Street 1:6421 MCKINNEY RANCH PKWY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-1860
Practice Address - Country:US
Practice Address - Phone:972-445-9844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118536235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist