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General NPI Number Information
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NPI Number | 1457887887
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Entity Type | Organization
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Legal Business Name | KIDS AND ADULTS THERAPY SERVICES
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 21304 PROVINCIAL BLVD
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City | KATY
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State | TX
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Zip | 77450-7580
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Country | US
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Telephone | 713-824-2292
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Fax | 800-803-7888
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Provider Business Mailing Address
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Address Line | 21304 PROVINCIAL BLVD
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City | KATY
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State | TX
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Zip | 77450-7580
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Country | US
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Telephone | 713-824-2292
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Fax | 800-803-7888
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Authorized Official
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Title or Position | OWNER, SPEECH PATHOLOGIST
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Name | MS. CRYSTAL ROSS
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Credential | M. ED., CCC-SLP
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Telephone | 832-293-0660
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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 | 16459
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License Number State | TX
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