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General NPI Number Information
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NPI Number | 1386826162
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Entity Type | Organization
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Legal Business Name | THE SPEECH CABOOSE
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 6003 CRESTFORD PARK LN
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City | HOUSTON
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State | TX
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Zip | 77084-6454
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Country | US
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Telephone | 713-817-7764
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Fax | 281-345-4599
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Provider Business Mailing Address
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Address Line | 6003 CRESTFORD PARK LN
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City | HOUSTON
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State | TX
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Zip | 77084-6454
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Country | US
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Telephone | 713-817-7764
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Fax | 281-345-4599
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | WILLIAMS MORJAN WILLIAMS
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Credential | MED., CCC-SLP
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Telephone | 713-817-7764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 100097
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License Number State | TX
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