MEDICARE: JOYFUL JOURNEY PEDIATRIC SPEECH AND FEEDING THERAPY, PLLC

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1548028681
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOYFUL JOURNEY PEDIATRIC SPEECH AND FEEDING THERAPY, PLLC

Provider Business Mailing Address
First Line	:	18383 PRESTON RD STE 202
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-5487
Country	:	US
Telephone Number	:	469-213-8455
Fax Number	:	469-574-5152

Provider Business Practice Location Address
First Line	:	3812 ISLAND CT
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-6306
Country	:	US
Telephone Number	:	214-552-0950
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TANYA MICHELLE RAINEY
Credential	:	M.S., CCC-SLP
Telephone Number	:	469-213-8455

Provider Enumeration Date	:	03/12/2024
Last Update Date	:	03/20/2024

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