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General NPI Number Information
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NPI Number | 1518356195
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Entity Type | Organization
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Legal Business Name | EXCEPTIONAL PEDIATRIC THERAPY @ HOME, PLLC
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Dates
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Enumeration Date | 01/20/2015
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Last Update Date | 01/20/2015
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Provider Practice Location Address
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Address Line | 9610 LONG POINT RD STE 120
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City | HOUSTON
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State | TX
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Zip | 77055-4265
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Country | US
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Telephone | 832-487-9872
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Fax | 832-487-9880
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Provider Business Mailing Address
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Address Line | 9610 LONG POINT RD STE 120
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City | HOUSTON
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State | TX
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Zip | 77055-4265
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Country | US
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Telephone | 832-487-9872
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Fax | 832-487-9880
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | NEDRA GENELLE WOODS
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Credential | CCC/SLP
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Telephone | 832-487-9872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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