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General NPI Number Information
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NPI Number | 1568660892
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Entity Type | Organization
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Legal Business Name | SPEECH SUCCESS, LLC
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Dates
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Enumeration Date | 07/09/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 1701 DOVE AVE STE D
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City | MCALLEN
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State | TX
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Zip | 78504-3955
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Country | US
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Telephone | 956-664-9395
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Fax | 956-661-9495
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Provider Business Mailing Address
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Address Line | 1701 DOVE AVE STE D
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City | MCALLEN
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State | TX
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Zip | 78504-3955
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Country | US
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Telephone | 956-664-9395
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Fax | 956-661-9495
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. FAVIOLA H TREVINO
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Credential | M.A., CCC-SLP
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Telephone | 956-664-9395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 19324
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License Number State | TX
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