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General NPI Number Information
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NPI Number | 1275179855
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Entity Type | Organization
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Legal Business Name | IPPOLITO SPEECH-LANGUAGE THERAPY SERVICES, P.L.L.C.
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Dates
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Enumeration Date | 11/19/2019
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Last Update Date | 11/19/2019
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Provider Practice Location Address
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Address Line | 1200 MAIN ST APT 1001
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City | DALLAS
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State | TX
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Zip | 75202-4303
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Country | US
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Telephone | 469-442-5105
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 MAIN ST APT 1001
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City | DALLAS
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State | TX
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Zip | 75202-4303
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Country | US
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Telephone | 469-442-5105
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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 | MARTA IPPOLITO
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Credential | M.S., CCC-SLP
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Telephone | 469-442-5105
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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 |
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License Number State |
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