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General NPI Number Information
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NPI Number | 1225539810
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Entity Type | Individual
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Provider Name | MARY ALICE NEWTON SLP-CCC
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Gender | Female
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Dates
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Enumeration Date | 02/28/2018
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Last Update Date | 02/28/2018
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Provider Practice Location Address
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Address Line | 3918 ATASCOCITA RD APT 536
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City | HUMBLE
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State | TX
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Zip | 77396-4460
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Country | US
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Telephone | 337-965-0535
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Fax |
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Provider Business Mailing Address
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Address Line | 265 A A MEYERS RD
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City | SULPHUR
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State | LA
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Zip | 70665-7595
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Country | US
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Telephone | 337-965-0535
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 111604
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License Number State | TX
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