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General NPI Number Information
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NPI Number | 1699438838
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Entity Type | Organization
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Legal Business Name | LIFESPAN SPEECH AND SWALLOW THERAPY PLLC
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 20658 STONE OAK PKWY UNIT 101
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City | SAN ANTONIO
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State | TX
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Zip | 78258-7361
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Country | US
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Telephone | 210-876-5282
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Fax | 210-864-2199
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Provider Business Mailing Address
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Address Line | 20658 STONE OAK PKWY UNIT 101
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City | SAN ANTONIO
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State | TX
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Zip | 78258-7361
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Country | US
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Telephone | 210-876-5282
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Fax | 210-864-2199
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Authorized Official
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Title or Position | OWNER/SPEECH PATHOLOGIST
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Name | KATHERIN OIGBOKIE
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Credential | SLP
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Telephone | 210-876-5282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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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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