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General NPI Number Information
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NPI Number | 1508543844
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Entity Type | Organization
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Legal Business Name | GLADSTONE SPEECH
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Dates
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Enumeration Date | 06/29/2023
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 2610 SPRING BEND DR
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City | SPRING
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State | TX
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Zip | 77386-2570
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Country | US
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Telephone | 202-380-7321
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Fax |
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Provider Business Mailing Address
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Address Line | 2610 SPRING BEND DR
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City | SPRING
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State | TX
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Zip | 77386-2570
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Country | US
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Telephone | 202-380-7321
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Fax |
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Authorized Official
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Title or Position | EMPLOYEE
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Name | MACARENA MANRIQUEZ MUNOZ
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Credential |
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Telephone | 202-380-7321
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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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