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General NPI Number Information
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NPI Number | 1720414535
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Entity Type | Organization
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Legal Business Name | SPEECH FOR KIDS THERAPY
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Dates
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Enumeration Date | 09/25/2013
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 37 VICTORIA RANCH LN
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-6122
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Country | US
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Telephone | 956-573-8892
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Fax |
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Provider Business Mailing Address
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Address Line | 37 VICTORIA RANCH LN
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-6122
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGY ASSISTANT
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Name | PRISCILLA GUTIERREZ
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Credential |
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Telephone | 956-573-8892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 34790
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License Number State | TX
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