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General NPI Number Information
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NPI Number | 1730491523
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Entity Type | Organization
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Legal Business Name | SPECIALIZED THERAPY RESOURCES, L.L.C.
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Dates
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Enumeration Date | 07/08/2010
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Last Update Date | 07/08/2010
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Provider Practice Location Address
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Address Line | 4301 DRUID LN
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City | DALLAS
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State | TX
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Zip | 75205-1028
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Country | US
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Telephone | 469-348-8691
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Fax |
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Provider Business Mailing Address
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Address Line | 4301 DRUID LN
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City | DALLAS
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State | TX
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Zip | 75205-1028
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Country | US
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Telephone | 469-348-8691
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR
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Name | MS. AMANDA K RUTHERFORD
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Credential | M.S. CCC/SLP
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Telephone | 469-348-8691
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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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