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General NPI Number Information
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NPI Number | 1679200299
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Entity Type | Individual
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Provider Name | CAMILA DOUGLAS SLPA
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Gender | Female
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Dates
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Enumeration Date | 08/03/2022
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Last Update Date | 08/03/2022
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Provider Practice Location Address
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Address Line | 13915 BURNET RD STE 204
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City | AUSTIN
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State | TX
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Zip | 78728-6537
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Country | US
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Telephone | 512-583-3792
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Fax |
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Provider Business Mailing Address
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Address Line | 9323 MENCHACA RD APT 424
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City | AUSTIN
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State | TX
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Zip | 78748-6245
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Country | US
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Telephone | 915-503-3880
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 42581
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License Number State | TX
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