Provider Demographics
NPI:1417403932
Name:VOICE DIAGNOSTIX, LLC
Entity Type:Organization
Organization Name:VOICE DIAGNOSTIX, LLC
Other - Org Name:VOICE DIAGNOSTIX
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNICKERBOCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-262-3773
Mailing Address - Street 1:6462 FORTUNE RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-7318
Mailing Address - Country:US
Mailing Address - Phone:817-262-3773
Mailing Address - Fax:
Practice Address - Street 1:6462 FORTUNE RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-7318
Practice Address - Country:US
Practice Address - Phone:817-262-3773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty