MEDICARE: THE SPEECH PLACE

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	100791	TX

General Provider Information

NPI Number	:	1790106094
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE SPEECH PLACE

Provider Business Mailing Address
First Line	:	2619 POMERAN DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-3826
Country	:	US
Telephone Number	:	281-242-1117
Fax Number	:	713-934-8923

Provider Business Practice Location Address
First Line	:	13313 SOUTHWEST FWY STE 108
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3660
Country	:	US
Telephone Number	:	281-242-1117
Fax Number	:	713-934-8923

Authorized Official
Title or Position	:	SPEECH PATHOLOGIST/ OWNER
Name	:	MRS. ALLISON LYNN ABBOTT
Credential	:	MS CCC-SLP
Telephone Number	:	281-242-1117

Provider Enumeration Date	:	01/03/2014
Last Update Date	:	01/03/2014

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Directions to “THE SPEECH PLACE ” Practice Location

Language	Start Address	Practice Location

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