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General NPI Number Information
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NPI Number | 1912298613
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Entity Type | Organization
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Legal Business Name | PUZZLE PIECE KIDS PEDIATRIC THERAPIES, LLC
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Dates
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Enumeration Date | 04/28/2011
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Last Update Date | 04/28/2011
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Provider Practice Location Address
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Address Line | 4925 GREENVILLE AVE SUITE 200
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City | DALLAS
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State | TX
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Zip | 75206-4026
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Country | US
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Telephone | 214-988-5437
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Fax | 972-552-2152
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Provider Business Mailing Address
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Address Line | 4925 GREENVILLE AVE SUITE 200
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City | DALLAS
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State | TX
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Zip | 75206-4026
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Country | US
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Telephone | 214-988-5437
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Fax | 972-552-2152
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Authorized Official
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Title or Position | CEO/SPEECH-LANGUAGE PATHOLOGIST
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Name | MRS. NATALIE JONES EVANS
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Credential | M.S.,CCC-SLP
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Telephone | 214-625-2218
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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 | 105978
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License Number State | TX
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