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General NPI Number Information
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NPI Number | 1114587870
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Entity Type | Organization
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Legal Business Name | R.E.A.C.T. INITIATIVE, INC.
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Dates
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Enumeration Date | 06/15/2019
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Last Update Date | 06/15/2019
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Provider Practice Location Address
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Address Line | 2360 COMANCHE TRL
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-8595
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Country | US
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Telephone | 301-974-2871
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Fax |
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Provider Business Mailing Address
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Address Line | 2360 COMANCHE TRL
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-8595
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Country | US
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Telephone | 301-974-2871
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. DIONNA LOUISE LATIMER-HEARN
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Credential | PH.D., CCC-SLP
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Telephone | 301-974-2871
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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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