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NPI Code Detail

MEDICARE: CONSTANCE ANN PROCHASKA MS, CCC-SLP

MEDICARE: CONSTANCE ANN PROCHASKA MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist18816TX

General Provider Information

NPI Number : 1851818108
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONSTANCE ANN PROCHASKA MS, CCC-SLP
Provider Business Mailing Address
First Line : 4528 TUXFORD CT
Second Line :
City : PLANO
State : TX
Zip : 75093-7148
Country : US
Telephone Number : 214-762-0036
Fax Number :
Provider Business Practice Location Address
First Line : 2825 VALLEY VIEW LN STE 100
Second Line :
City : FARMERS BRANCH
State : TX
Zip : 75234-4943
Country : US
Telephone Number : 214-736-8376
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2017
Last Update Date : 06/16/2018

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Directions to “ CONSTANCE ANN PROCHASKA MS, CCC-SLP” Practice Location

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