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General NPI Number Information
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NPI Number | 1225383466
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Entity Type | Organization
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Legal Business Name | LEAPS WITH LANGUAGE
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Dates
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Enumeration Date | 07/13/2012
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Last Update Date | 07/13/2012
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Provider Practice Location Address
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Address Line | 4107 MEDICAL PKWY STE 200
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City | AUSTIN
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State | TX
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Zip | 78756-3729
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Country | US
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Telephone | 512-573-7486
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Fax |
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Provider Business Mailing Address
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Address Line | 4107 MEDICAL PKWY STE 200
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City | AUSTIN
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State | TX
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Zip | 78756-3729
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Country | US
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Telephone | 512-573-7486
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | AMANDA LOUISE NITSCHKE
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Credential | M.S. CCC
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Telephone | 512-573-7486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 100867
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License Number State | TX
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