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General NPI Number Information
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NPI Number | 1649005679
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Entity Type | Organization
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Legal Business Name | LADYBUG LACTATION AND FEEDING THERAPY
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 7254 BLANCO RD STE 204
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City | SAN ANTONIO
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State | TX
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Zip | 78216-4930
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Country | US
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Telephone | 210-724-6498
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 762391
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City | SAN ANTONIO
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State | TX
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Zip | 78245-7391
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Country | US
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Telephone | 210-201-6144
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | LYDIA JEAN MARTINEZ
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Credential | M.A., CCC-SLP, CBS
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Telephone | 210-201-6144
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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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