Provider Demographics
NPI:1023484466
Name:FUSION SPEECH THERAPY SERVICES PLLC
Entity type:Organization
Organization Name:FUSION SPEECH THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN/SLP
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PECINA
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:956-463-4949
Mailing Address - Street 1:2717 FAIRMONT AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6498
Mailing Address - Country:US
Mailing Address - Phone:956-463-4949
Mailing Address - Fax:956-587-0245
Practice Address - Street 1:2717 FAIRMONT AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6498
Practice Address - Country:US
Practice Address - Phone:956-463-4949
Practice Address - Fax:956-587-0245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106746235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty