Active NPI
Maritess Estrevillo Dimaliwat, SLP
- Speech-Language Pathologist
- Pinetop, AZ
National Provider Identifier
1841324894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLPL5347
- Practice address
- 5893 Mule Deer Way
Pinetop, AZ 85935-8665 - Phone
- (928) 338-4138
- NPI assigned
- Mar 14, 2007
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLPL5347 | AZ | Primary |
Addresses
Primary practice location
5893 Mule Deer Way
Pinetop, AZ 85935-8665
Mailing address
PO Box 1973
Pinetop, AZ 85935-1973
Phone (917) 453-2362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLPL5347 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1841324894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1973",
"city": "PINETOP",
"state": "AZ",
"postal_code": "859351973",
"telephone_number": "917-453-2362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5893 MULE DEER WAY",
"city": "PINETOP",
"state": "AZ",
"postal_code": "859358665",
"telephone_number": "928-338-4138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMALIWAT",
"first_name": "MARITESS",
"middle_name": "ESTREVILLO",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "SLPL5347",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pinetop, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.