Provider Demographics
NPI:1790143113
Name:TALKING TADPOLES, LLC
Entity Type:Organization
Organization Name:TALKING TADPOLES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULISSA
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:IRACHETA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:682-500-1958
Mailing Address - Street 1:8101 BOAT CLUB RD STE 330
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-3633
Mailing Address - Country:US
Mailing Address - Phone:682-500-1958
Mailing Address - Fax:214-935-2457
Practice Address - Street 1:833 TOWNE CT
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:TX
Practice Address - Zip Code:76179-1280
Practice Address - Country:US
Practice Address - Phone:214-302-9725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-29
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty