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General NPI Number Information
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NPI Number | 1619116290
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Entity Type | Organization
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Legal Business Name | PATHWAY SPEECH AND LANGUAGE
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Dates
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Enumeration Date | 02/05/2009
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Last Update Date | 02/05/2009
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Provider Practice Location Address
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Address Line | 206 E COLLEGE ST SUITE 200
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City | GRAPEVINE
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State | TX
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Zip | 76051-5364
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Country | US
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Telephone | 817-913-4999
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Fax |
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Provider Business Mailing Address
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Address Line | 206 E COLLEGE ST SUITE 200
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City | GRAPEVINE
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State | TX
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Zip | 76051-5364
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Country | US
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Telephone | 817-913-4999
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | GAIL LINDLEY
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Credential | MS, CCC/SLP
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Telephone | 817-913-4999
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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 | 17767
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License Number State | TX
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