Healthcare Provider Details
I. General information
NPI: 1013104835
Provider Name (Legal Business Name): TREEHOUSE THERAPIES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/25/2007
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
701 S ZARZAMORA ST
SAN ANTONIO TX
78207-5209
US
IV. Provider business mailing address
10515 GULFDALE
SAN ANTONIO TX
78216-3602
US
V. Phone/Fax
- Phone: 210-340-2627
- Fax: 210-340-6437
- Phone: 210-340-2627
- Fax: 210-340-6437
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
MARCI
R
TAYLOR
Title or Position: EXECUTIVE DIRECTOR
Credential: OTR,BCABA
Phone: 210-340-2627