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General NPI Number Information
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NPI Number | 1043648504
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Entity Type | Organization
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Legal Business Name | SPEECH ESSENTIALS THERAPY
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Dates
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Enumeration Date | 10/21/2013
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Last Update Date | 10/21/2013
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Provider Practice Location Address
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Address Line | 1001 E REDBUD AVE
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City | MCALLEN
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State | TX
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Zip | 78504-2616
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Country | US
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Telephone | 956-451-0643
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 E REDBUD AVE
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City | MCALLEN
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State | TX
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Zip | 78504-2616
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARMEN RINCON
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Credential | SLP
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Telephone | 956-451-0643
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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 | 106665
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License Number State | TX
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