Provider Demographics
NPI:1073939237
Name:PREMIER SPEECH & SWALLOWING SOLUTIONS LLC
Entity Type:Organization
Organization Name:PREMIER SPEECH & SWALLOWING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VONETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK-ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:281-717-4308
Mailing Address - Street 1:18502 GREEN LAND WAY STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-7967
Mailing Address - Country:US
Mailing Address - Phone:281-717-4308
Mailing Address - Fax:877-886-0898
Practice Address - Street 1:18502 GREEN LAND WAY STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7967
Practice Address - Country:US
Practice Address - Phone:281-717-4308
Practice Address - Fax:877-886-0898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-12
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 235Z00000X
TX101079235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty