Provider Demographics
NPI:1316820723
Name:CHAIREZ-CEBALLOS, MARTHA ALEJANDRA
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:ALEJANDRA
Last Name:CHAIREZ-CEBALLOS
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 1:2917 SLIDELL AVE
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-4421
Mailing Address - Country:US
Mailing Address - Phone:985-768-9772
Mailing Address - Fax:985-768-9772
Practice Address - Street 1:3501 SEINE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6704
Practice Address - Country:US
Practice Address - Phone:504-941-1810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9902235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist