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General NPI Number Information
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NPI Number | 1326570409
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Entity Type | Organization
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Legal Business Name | SHINE ON THERAPIES OF AUSTIN PLLC
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 201 S LAKELINE BLVD SUITE 901-F
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City | CEDAR PARK
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State | TX
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Zip | 78613-2718
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Country | US
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Telephone | 512-813-0667
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Fax |
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Provider Business Mailing Address
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Address Line | 201 S LAKELINE BLVD SUITE 901-F
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City | CEDAR PARK
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State | TX
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Zip | 78613-2718
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER/SPEECH-LANGUAGE PATHOLOGIST
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Name | ANNE CHEN
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Credential |
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Telephone | 512-813-0667
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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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