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General NPI Number Information
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NPI Number | 1962923334
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Entity Type | Organization
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Legal Business Name | FRISCO FEEDING & SPEECH THERAPY
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 11330 LEGACY DR STE 306
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City | FRISCO
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State | TX
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Zip | 75033-1217
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Country | US
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Telephone | 469-630-2328
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Fax |
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Provider Business Mailing Address
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Address Line | 11330 LEGACY DR STE 306
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City | FRISCO
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State | TX
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Zip | 75033-1217
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Country | US
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Telephone | 469-630-2328
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEANINE RODDY
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Credential | CCC-SLP
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Telephone | 469-632-2328
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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 | 111744
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License Number State | TX
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