MEDICARE: S.O.A.R. BEYOND NEURODIVERSE THERAPY

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	:	1861324188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S.O.A.R. BEYOND NEURODIVERSE THERAPY

Provider Business Mailing Address
First Line	:	17519 PANORAMA DR
Second Line	:
City	:	DRIPPING SPRINGS
State	:	TX
Zip	:	78620-2525
Country	:	US
Telephone Number	:	818-624-1335
Fax Number	:

Provider Business Practice Location Address
First Line	:	17519 PANORAMA DR
Second Line	:
City	:	DRIPPING SPRINGS
State	:	TX
Zip	:	78620-2525
Country	:	US
Telephone Number	:	818-624-1335
Fax Number	:

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST
Name	:	NORA SIMKO
Credential	:	M.S., CCC-SLP
Telephone Number	:	818-624-1335

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Language	Start Address	Practice Location

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