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General NPI Number Information
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NPI Number | 1871158253
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Entity Type | Organization
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Legal Business Name | KJB SPEECH THERAPY PLLC
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Dates
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Enumeration Date | 05/01/2019
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 2045 SPACE PARK DR STE 140
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City | HOUSTON
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State | TX
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Zip | 77058-6305
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Country | US
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Telephone | 832-769-3122
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Fax | 832-769-3059
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Provider Business Mailing Address
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Address Line | 2336 SHALLOW CREEK LN
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-1506
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Country | US
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Telephone | 832-769-3122
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Fax |
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Authorized Official
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Title or Position | OWNER/LEAD THERAPIST
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Name | KISA JEANNETTE BRACEY
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Credential | CCC-SLP
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Telephone | 832-217-9410
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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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