Provider Demographics
NPI:1295222735
Name:FARM TO FUNCTION, LLC
Entity Type:Organization
Organization Name:FARM TO FUNCTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSABROOK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:214-908-2401
Mailing Address - Street 1:611 RUBY CV
Mailing Address - Street 2:
Mailing Address - City:OAK POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75068-2254
Mailing Address - Country:US
Mailing Address - Phone:214-908-2401
Mailing Address - Fax:
Practice Address - Street 1:5098 US HIGHWAY 377 S
Practice Address - Street 2:
Practice Address - City:KRUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:76227-6210
Practice Address - Country:US
Practice Address - Phone:214-908-2401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118187225X00000X
TX102657235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty