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General NPI Number Information
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NPI Number | 1437398625
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Entity Type | Individual
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Provider Name | ANN NUNNALLY CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 2109 W SPRING CREEK PKWY SUITE 200
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City | PLANO
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State | TX
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Zip | 75023-4189
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Country | US
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Telephone | 972-964-7073
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Fax | 972-943-3441
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Provider Business Mailing Address
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Address Line | 2109 W SPRING CREEK PKWY SUITE 200
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City | PLANO
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State | TX
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Zip | 75023-4189
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Country | US
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Telephone | 972-964-7073
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Fax | 972-943-3441
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 100884
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License Number State | TX
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