MEDICARE: DIVERSE SPEECH THERAPY SOLUTIONS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1255030854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVERSE SPEECH THERAPY SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	1600 NE LOOP 410 STE 217
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1633
Country	:	US
Telephone Number	:	210-829-5777
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 NE LOOP 410 STE 217
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1633
Country	:	US
Telephone Number	:	210-829-5777
Fax Number	:

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST/COOWNER
Name	:	MS. VERONICA LEAL BOTELLO
Credential	:	M.A. CCC-SLP
Telephone Number	:	210-829-5777

Provider Enumeration Date	:	03/02/2023
Last Update Date	:	06/18/2025

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Directions to “DIVERSE SPEECH THERAPY SOLUTIONS, LLC ” Practice Location

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