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General NPI Number Information
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NPI Number | 1306190111
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Entity Type | Organization
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Legal Business Name | CARLA AUBREY - SPEECH PATHOLOGIST, LLC
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Dates
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Enumeration Date | 10/31/2012
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Last Update Date | 10/31/2012
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Provider Practice Location Address
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Address Line | 7161 KENDALLWOOD DR
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City | DALLAS
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State | TX
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Zip | 75240-5510
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Country | US
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Telephone | 213-636-4034
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Fax |
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Provider Business Mailing Address
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Address Line | 7161 KENDALLWOOD DR
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City | DALLAS
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State | TX
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Zip | 75240-5510
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Country | US
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Telephone | 213-636-4034
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. CARLA C AUBREY
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Credential | SLP
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Telephone | 214-636-4034
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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 | 16272
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License Number State | TX
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