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General NPI Number Information
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NPI Number | 1336833722
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Entity Type | Organization
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Legal Business Name | LONGHORN SPEECH SERVICES AND DYSPHAGIA DIAGNOSTICS
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Dates
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Enumeration Date | 06/07/2023
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 32880 INTERSTATE 10 W # 104
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City | BOERNE
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State | TX
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Zip | 78006-9292
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Country | US
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Telephone | 210-504-8019
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Fax |
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Provider Business Mailing Address
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Address Line | 9623 BOERNE SPG
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City | BOERNE
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State | TX
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Zip | 78006-9394
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Country | US
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Telephone | 248-231-6488
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEGHAN MCDONALD
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Credential | SLP
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Telephone | 248-231-6488
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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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