Provider Demographics
NPI:1508543844
Name:GLADSTONE SPEECH
Entity type:Organization
Organization Name:GLADSTONE SPEECH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:MACARENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANRIQUEZ MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-380-7321
Mailing Address - Street 1:2610 SPRING BEND DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-2570
Mailing Address - Country:US
Mailing Address - Phone:202-380-7321
Mailing Address - Fax:
Practice Address - Street 1:2610 SPRING BEND DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-2570
Practice Address - Country:US
Practice Address - Phone:202-380-7321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-29
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty