MEDICARE: SPEECH MONSTER 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	261QR0400X	Rehabilitation Clinic/Center	102175	TX

General Provider Information

NPI Number	:	1568840999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEECH MONSTER LLC

Provider Business Mailing Address
First Line	:	10130 GRANT RD
Second Line	:	#218
City	:	HOUSTON
State	:	TX
Zip	:	77070-4531
Country	:	US
Telephone Number	:	281-807-6325
Fax Number	:

Provider Business Practice Location Address
First Line	:	10130 GRANT RD
Second Line	:	SUITE 218
City	:	HOUSTON
State	:	TX
Zip	:	77070-4531
Country	:	US
Telephone Number	:	281-807-6325
Fax Number	:

Authorized Official
Title or Position	:	OWNER, CHIEF EXECUTIVE
Name	:	MR. MITCHELL STONER MATSON
Credential	:
Telephone Number	:	281-807-6325

Provider Enumeration Date	:	05/18/2015
Last Update Date	:	01/04/2016

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Directions to “SPEECH MONSTER LLC ” Practice Location

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