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General NPI Number Information
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NPI Number | 1023747631
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Entity Type | Organization
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Legal Business Name | WEST STATE SPEECH PARTNERS, LLC
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Dates
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Enumeration Date | 06/08/2022
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 720 RUSK ST
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City | NEWTON
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State | TX
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Zip | 75966-3236
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Country | US
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Telephone | 337-208-4615
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Fax |
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Provider Business Mailing Address
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Address Line | 379 PEAVY RD
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City | LEESVILLE
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State | LA
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Zip | 71446-9514
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Country | US
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Telephone | 337-208-4615
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Fax |
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Authorized Official
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Title or Position | OWNER/SLP
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Name | SHARON BELL GRANGER
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Credential | MCD, CCC-SLP
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Telephone | 337-208-4615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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