Provider Demographics
NPI:1073054193
Name:SPEECH 4 FUN THERAPEUTIC SERVICES, PLLC
Entity Type:Organization
Organization Name:SPEECH 4 FUN THERAPEUTIC SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:PFISTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC/SLP, COM
Authorized Official - Phone:214-274-9400
Mailing Address - Street 1:5109 MALVERN DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4935
Mailing Address - Country:US
Mailing Address - Phone:214-274-9400
Mailing Address - Fax:214-380-9409
Practice Address - Street 1:8105 RASOR BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-0116
Practice Address - Country:US
Practice Address - Phone:214-274-9400
Practice Address - Fax:214-380-9409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100919235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty