Healthcare Provider Details

I. General information

NPI: 1205127537
Provider Name (Legal Business Name): KATHRYN HUMPHREYS SCHOPFER MS/CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 04/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 N WASHINGTON AVE
DALLAS TX
75246-1520
US

IV. Provider business mailing address

6512 ANITA ST
DALLAS TX
75214-2706
US

V. Phone/Fax

Practice location:
  • Phone: 214-820-9539
  • Fax: 214-820-9369
Mailing address:
  • Phone: 214-827-0817
  • Fax: 214-820-9369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14166
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: