Healthcare Provider Details

I. General information

NPI: 1821424979
Provider Name (Legal Business Name): PUZZLE PIECE KIDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2013
Last Update Date: 09/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 W KEARNEY ST SUITE 200
MESQUITE TX
75149-3401
US

IV. Provider business mailing address

502 W KEARNEY ST SUITE 200
MESQUITE TX
75149-3401
US

V. Phone/Fax

Practice location:
  • Phone: 972-288-8100
  • Fax: 800-921-7173
Mailing address:
  • Phone: 972-288-8100
  • Fax: 800-921-7173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. NATALIE J EVANS
Title or Position: PRESIDENT
Credential: MS, CCC-SLP
Phone: 972-288-8100