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General NPI Number Information
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NPI Number | 1144745787
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Entity Type | Organization
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Legal Business Name | FLATLAND THERAPY, PLLC
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Dates
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Enumeration Date | 08/04/2017
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Last Update Date | 08/04/2017
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Provider Practice Location Address
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Address Line | 4011 88TH ST
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City | LUBBOCK
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State | TX
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Zip | 79423-2912
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Country | US
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Telephone | 806-777-9989
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 53333
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City | LUBBOCK
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State | TX
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Zip | 79453-3333
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Country | US
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Telephone | 806-777-9989
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Fax |
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Authorized Official
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Title or Position | OWNER, SPEECH-LANGUAGE PATHOLOGIST
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Name | AMANDA ALAINE STEPHENS
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Credential | M.S., CCC-SLP
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Telephone | 806-777-9989
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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 | 105878
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License Number State | TX
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