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NPI 1316720865

NPI 1316720865 : WOODFOREST SPEECH THERAPY, PLLC : SPRING, TX

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General NPI Number Information
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    NPI Number           |    1316720865
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    Entity Type          |    Organization 
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    Legal Business Name  |    WOODFOREST SPEECH THERAPY, PLLC 
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Dates
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    Enumeration Date     |    08/17/2023
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    Last Update Date     |    08/17/2023
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Provider Practice Location Address
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    Address Line         |    21801 NORTHCREST DR APT 1935 
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    City                 |    SPRING
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    State                |    TX
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    Zip                  |    77388-4073
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    Country              |    US
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    Telephone            |    832-585-9604
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    21801 NORTHCREST DR APT 1935 
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    City                 |    SPRING
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    State                |    TX
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    Zip                  |    77388-4073
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    Country              |    US
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    Telephone            |    832-585-9604
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     STEPHANIE  POWELL 
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    Credential           |    M.S. CCC-SLP
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    Telephone            |    832-585-9604
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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       |    
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    License Number State |    
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