Provider Demographics
NPI:1013233485
Name:WISE THERAPY SERVICES
Entity Type:Organization
Organization Name:WISE THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NOHEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ-CLEMENT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:832-418-9274
Mailing Address - Street 1:PO BOX 9292
Mailing Address - Street 2:9450 PINECROFT DR.
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77387-9292
Mailing Address - Country:US
Mailing Address - Phone:832-418-9274
Mailing Address - Fax:281-288-2502
Practice Address - Street 1:2622 SPRINGSTONE DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-5464
Practice Address - Country:US
Practice Address - Phone:832-418-9274
Practice Address - Fax:281-288-2502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-10
Last Update Date:2010-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102122235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty