=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649167149
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JO-EPRISE BOHN-SAUVETERRE M.S., SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2025
-----------------------------------------------------
Last Update Date | 06/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1431 GREENWAY DR STE 500
-----------------------------------------------------
City | IRVING
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75038-2444
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-688-2520
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1639 CABLE RANCH RD APT 1204
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78245-1573
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-744-4187
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 123736
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------