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General NPI Number Information
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NPI Number | 1457021644
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Entity Type | Organization
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Legal Business Name | SPEECHOLOGY LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 09/17/2021
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 1214 DOLTON DR STE 202
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City | DALLAS
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State | TX
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Zip | 75207-2108
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Country | US
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Telephone | 940-290-0389
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 962416
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City | EL PASO
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State | TX
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Zip | 79996-2416
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Country | US
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Telephone | 940-290-0389
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST/OWNER
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Name | ELIZABETH GOMEZ
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Credential | MS.-CCC-SLP
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Telephone | 915-929-5972
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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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