Provider Demographics
NPI:1205183282
Name:PANHANDLE SPEECH THERAPY SERVICES PLLC
Entity Type:Organization
Organization Name:PANHANDLE SPEECH THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELI
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:806-274-1342
Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:
Mailing Address - City:PANHANDLE
Mailing Address - State:TX
Mailing Address - Zip Code:79068-0216
Mailing Address - Country:US
Mailing Address - Phone:806-274-1342
Mailing Address - Fax:
Practice Address - Street 1:312 EUCLID AVE.
Practice Address - Street 2:
Practice Address - City:PANHANDLE
Practice Address - State:TX
Practice Address - Zip Code:79068
Practice Address - Country:US
Practice Address - Phone:806-274-1342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty