Maximo Aquilizan Jr., SLP
Individual provider Active NPI Speech-Language Pathologist · Raytown, MO
NPI 1225751639 · NPPES record last updated Sep 21, 2022
Key facts
- NPI
- 1225751639
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2022033288 (MO)
- Practice address
- 6608 Raytown Rd
Raytown, MO 64133-5240 - Phone
- (818) 281-9172
- NPI assigned
- Sep 21, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022033288 | MO | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2022033288 | MO | Yes |
Addresses
Primary practice location
6608 Raytown Rd
Raytown, MO 64133-5240
Mailing address
6608 Raytown Rd
Raytown, MO 64133-5240
Other providers in Raytown, MO
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- Marika Amrine
- Madison Suzanne Anderson
- Angelic Home Health Care
- Ashay LLC
- Assisting Hands Touching Hearts, LLC
- Kara Eileen Azotea
- Sherri Baker
- Charles A Banks
All providers in Raytown, MO · Speech-Language Pathologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.