Individual ProviderOliva Nicole CantuSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address1202 E Sonterra Blvd Ste 609, San Antonio, TX 78258-4093(210) 891-0800PECOS EnrollmentBased on the most recent information from CMS, provider Oliva Nicole Cantu does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1548936768Provider TypeIndividualFull NameCantu, Oliva NicoleCredentialMS, CCC-SLPGenderFemaleSole ProprietorNoEnumeration Date8/18/2021Last Updated8/18/2021Contact InformationPractice LocationPractice Address1202 E Sonterra Blvd Ste 609, San Antonio, TX 78258-4093Phone(210) 891-0800Fax(210) 891-0888Mailing LocationMailing Address1202 E Sonterra Blvd Ste 609, San Antonio, TX 78258-4093Phone(210) 891-0800Fax(210) 891-0888Provider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense116014Texas