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General NPI Number Information
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NPI Number | 1780404202
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Entity Type | Organization
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Legal Business Name | SPEECH FOUNDATIONS PLLC
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 1323 COUNTY ROAD 92
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City | CAT SPRING
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State | TX
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Zip | 78933-5499
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Country | US
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Telephone | 979-217-1813
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Fax |
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Provider Business Mailing Address
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Address Line | 1323 COUNTY ROAD 92
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City | CAT SPRING
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State | TX
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Zip | 78933-5499
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Country | US
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Telephone | 979-217-1813
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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 | KASSIE CHAFFIN
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Credential | CCC-SLP
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Telephone | 832-693-1307
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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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