Provider Demographics
NPI:1275033482
Name:HENDERSON SPEECH THERAPY PLLC
Entity Type:Organization
Organization Name:HENDERSON SPEECH THERAPY PLLC
Other - Org Name:SPEECH NEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:STACI
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:469-730-6378
Mailing Address - Street 1:9720 COIT RD STE 220
Mailing Address - Street 2:#186
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5847
Mailing Address - Country:US
Mailing Address - Phone:469-730-6378
Mailing Address - Fax:469-605-2675
Practice Address - Street 1:9720 COIT RD STE 220
Practice Address - Street 2:#186
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-5847
Practice Address - Country:US
Practice Address - Phone:469-730-6378
Practice Address - Fax:469-605-2675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-14
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19852261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech