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General NPI Number Information
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NPI Number | 1104839786
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Entity Type | Organization
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Legal Business Name | SPEECH ENTERPRISES, INC.
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3111 W ARKANSAS LN
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City | ARLINGTON
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State | TX
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Zip | 76016-5826
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Country | US
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Telephone | 817-460-0378
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Fax | 817-469-1195
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Provider Business Mailing Address
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Address Line | 3111 W ARKANSAS LN
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City | ARLINGTON
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State | TX
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Zip | 76016-5826
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Country | US
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Telephone | 817-460-0378
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Fax | 817-469-1195
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Authorized Official
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Title or Position | PRESIDENT
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Name | DENISE GAGE
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Credential | M.A., CCC
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Telephone | 817-460-0378
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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 | 102120
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 10121
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License Number State | TX
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