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General NPI Number Information
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NPI Number | 1093139511
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Entity Type | Organization
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Legal Business Name | ALISA PREWITT AND ASSOCIATES
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Dates
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Enumeration Date | 02/05/2014
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 24044 CINCO VILLAGE CENTER BLVD STE 100
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City | KATY
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State | TX
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Zip | 77494-8432
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Country | US
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Telephone | 281-392-8173
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Fax | 281-392-8239
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Provider Business Mailing Address
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Address Line | 22507 MOSSY TRAILS CT
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City | KATY
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State | TX
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Zip | 77494-2255
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Country | US
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Telephone | 281-392-8173
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Fax | 281-392-8239
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ALISA PREWITT
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Credential | M.A.
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Telephone | 281-392-8173
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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 | 100951
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License Number State | TX
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