Provider Demographics
NPI:1417631243
Name:DINOMITE SPEECH THERAPY PLLC
Entity Type:Organization
Organization Name:DINOMITE SPEECH THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEIGH
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:M S CCC-SLP
Authorized Official - Phone:806-318-6783
Mailing Address - Street 1:6213 ETHAN LN
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-6924
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2300 N WESTERN ST STE 130
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-1716
Practice Address - Country:US
Practice Address - Phone:806-318-6783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty