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General NPI Number Information
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NPI Number | 1407641921
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Entity Type | Organization
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Legal Business Name | ROOCALOO THERAPY, PLLC
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 811 S INTERURBAN ST STE B
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City | ANNA
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State | TX
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Zip | 75409-3626
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Country | US
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Telephone | 972-441-2434
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Fax |
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Provider Business Mailing Address
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Address Line | 231 PECAN HOLLOW CIR
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City | ANNA
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State | TX
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Zip | 75409-6294
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Country | US
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Telephone | 972-832-5229
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Fax |
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Authorized Official
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Title or Position | OWNER/SLP
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Name | CARRIE JOHNSON
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Credential | M.S, CCC-SLP
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Telephone | 972-832-5229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0010X
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Taxonomy Name | Pediatric Rehabilitation Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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