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General NPI Number Information
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NPI Number | 1720715626
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Entity Type | Organization
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Legal Business Name | GOOSE CREEK ISD
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Dates
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Enumeration Date | 08/02/2022
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Last Update Date | 09/02/2022
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Provider Practice Location Address
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Address Line | 403 E JAMES ST
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City | BAYTOWN
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State | TX
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Zip | 77520-5065
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Country | US
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Telephone | 281-420-4615
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Fax |
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Provider Business Mailing Address
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Address Line | 919 GILLETTE ST APT 1050
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City | HOUSTON
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State | TX
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Zip | 77019-2733
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Country | US
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Telephone | 713-825-0560
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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 | TERESA LAVERY HARRISON
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Credential | MS CCC SLP
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Telephone | 713-825-0650
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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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