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General NPI Number Information
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NPI Number | 1821667502
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Entity Type | Individual
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Provider Name | CASSIDY KLOEPPER MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/17/2021
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 8213 MID CITIES BLVD STE 200
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76182-4712
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Country | US
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Telephone | 972-521-6234
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Fax |
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Provider Business Mailing Address
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Address Line | 3701 GRAPEVINE MILLS PKWY APT 2134
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City | GRAPEVINE
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State | TX
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Zip | 76051-1934
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Country | US
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Telephone | 361-212-3368
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 116321
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License Number State | TX
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