Provider Demographics
NPI:1902815467
Name:KINER SPEECH SERVICES
Entity Type:Organization
Organization Name:KINER SPEECH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONGULA
Authorized Official - Middle Name:D
Authorized Official - Last Name:KINER
Authorized Official - Suffix:
Authorized Official - Credentials:MM,CCC-SLP
Authorized Official - Phone:817-652-1895
Mailing Address - Street 1:2887 PARK PLACE DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-8520
Mailing Address - Country:US
Mailing Address - Phone:817-652-1895
Mailing Address - Fax:
Practice Address - Street 1:2887 PARK PLACE DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-8520
Practice Address - Country:US
Practice Address - Phone:817-652-1895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17240235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty