Provider Demographics
NPI:1144412669
Name:SPEECH FOR LIFE THERAPY CENTER,P.C.
Entity Type:Organization
Organization Name:SPEECH FOR LIFE THERAPY CENTER,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PERRI
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:PALERMO
Authorized Official - Suffix:
Authorized Official - Credentials:MA,CCC-SLP
Authorized Official - Phone:713-927-2261
Mailing Address - Street 1:PO BOX 20281
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77225-0281
Mailing Address - Country:US
Mailing Address - Phone:713-927-2261
Mailing Address - Fax:713-218-8989
Practice Address - Street 1:3000 WESLAYAN ST
Practice Address - Street 2:SUITE 275
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5700
Practice Address - Country:US
Practice Address - Phone:713-927-2261
Practice Address - Fax:713-218-8988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0001NUOtherBLUE CROSS BLUE SHIELD