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General NPI Number Information
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NPI Number | 1629687264
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Entity Type | Organization
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Legal Business Name | ESLP CLINIC
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 260 DORSET LN
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City | AUSTIN
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State | TX
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Zip | 78737-4553
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Country | US
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Telephone | 512-710-6861
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Fax | 512-505-8354
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Provider Business Mailing Address
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Address Line | 260 DORSET LN
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City | AUSTIN
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State | TX
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Zip | 78737-4553
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Country | US
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Telephone | 512-710-6861
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Fax | 512-505-8354
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST /OWNER
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Name | KERRI L SALVATORE
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Credential | M.S., CCC-SLP
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Telephone | 512-710-6861
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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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