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General NPI Number Information
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NPI Number | 1073054193
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Entity Type | Organization
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Legal Business Name | SPEECH 4 FUN THERAPEUTIC SERVICES, PLLC
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Dates
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Enumeration Date | 03/09/2017
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Last Update Date | 03/09/2017
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Provider Practice Location Address
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Address Line | 8105 RASOR BLVD SUITE 102
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City | PLANO
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State | TX
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Zip | 75024-0116
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Country | US
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Telephone | 214-274-9400
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Fax | 214-380-9409
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Provider Business Mailing Address
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Address Line | 5109 MALVERN DR
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City | PLANO
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State | TX
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Zip | 75093-4935
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Country | US
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Telephone | 214-274-9400
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Fax | 214-380-9409
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KARA BETH PFISTER
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Credential | M.S. CCC/SLP, COM
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Telephone | 214-274-9400
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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 | 100919
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License Number State | TX
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