Provider Demographics
NPI:1265685580
Name:EDU-DULA, INC.
Entity Type:Organization
Organization Name:EDU-DULA, INC.
Other - Org Name:THE PEDIATRIC REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LETICIA
Authorized Official - Middle Name:LAURA
Authorized Official - Last Name:DULA
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC/SLP
Authorized Official - Phone:903-663-9946
Mailing Address - Street 1:PO BOX 9388
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75608-9388
Mailing Address - Country:US
Mailing Address - Phone:903-663-9946
Mailing Address - Fax:903-663-5580
Practice Address - Street 1:501 N SPUR 63
Practice Address - Street 2:SUITE B3
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5013
Practice Address - Country:US
Practice Address - Phone:903-663-9946
Practice Address - Fax:903-663-5580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty