Provider Demographics
NPI:1164613253
Name:MONKEY MOUTHS, LLC
Entity Type:Organization
Organization Name:MONKEY MOUTHS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BERNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:817-656-7240
Mailing Address - Street 1:309 HILL CREST DR
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-7122
Mailing Address - Country:US
Mailing Address - Phone:817-656-7240
Mailing Address - Fax:817-656-7251
Practice Address - Street 1:401 HARWOOD RD STE A
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4183
Practice Address - Country:US
Practice Address - Phone:817-656-7240
Practice Address - Fax:817-656-7251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18230235Z00000X
TX17222235Z00000X
TX16965235Z00000X
TX16662235Z00000X
TX19969235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty