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General NPI Number Information
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NPI Number | 1477842409
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Entity Type | Organization
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Legal Business Name | DIVERSE SPEECH THERAPY SOLUTIONS, LLC
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Dates
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Enumeration Date | 03/30/2011
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 1804 NE LOOP 410 220
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5211
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Country | US
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Telephone | 210-829-5777
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Fax | 210-829-5972
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Provider Business Mailing Address
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Address Line | PO BOX 17465
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City | SAN ANTONIO
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State | TX
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Zip | 78217-0465
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Country | US
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Telephone | 210-381-7534
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Fax | 210-592-7366
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Authorized Official
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Title or Position | SINGLE MEMBER/SLP
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Name | MRS. RUTH C BATTIATO
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Credential | CCC-SLP
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Telephone | 210-381-7534
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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 | 19156
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License Number State | TX
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