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NPI Code Detail

MEDICARE: RICHARDSON SPEECH & NEURO THERAPY PLLC

MEDICARE: RICHARDSON SPEECH & NEURO 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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1902489446
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICHARDSON SPEECH & NEURO THERAPY PLLC
Provider Business Mailing Address
First Line : 1002 CEDAR LN
Second Line :
City : RICHARDSON
State : TX
Zip : 75080-5909
Country : US
Telephone Number : 469-644-1650
Fax Number :
Provider Business Practice Location Address
First Line : 1002 CEDAR LN
Second Line :
City : RICHARDSON
State : TX
Zip : 75080-5909
Country : US
Telephone Number : 469-644-1650
Fax Number :
Authorized Official
Title or Position : SPEECH PATHOLOGIST
Name : AMANDA JOHNSON
Credential :
Telephone Number : 469-644-1650
Provider Enumeration Date : 05/03/2021
Last Update Date : 05/03/2021

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Directions to “RICHARDSON SPEECH & NEURO THERAPY PLLC ” Practice Location

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