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General NPI Number Information
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NPI Number | 1184710758
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Entity Type | Organization
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Legal Business Name | NORTH DALLAS THERAPY, PLLC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 11/10/2008
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Provider Practice Location Address
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Address Line | 2305 RIDGEWOOD DR
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City | PLANO
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State | TX
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Zip | 75074
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Country | US
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Telephone | 214-616-2932
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Fax | 214-473-8975
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Provider Business Mailing Address
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Address Line | 2305 RIDGEWOOD DR
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City | PLANO
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State | TX
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Zip | 75074
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Country | US
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Telephone | 214-616-2932
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Fax | 214-473-8975
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Authorized Official
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Title or Position | OWNER
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Name | MS. ERICKA KATHLEEN ERVIN
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Credential | LPT
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Telephone | 214-616-2932
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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 | 102130
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 112526
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1136505
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License Number State | TX
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