Provider Demographics
NPI:1720444771
Name:HOME SPEECH THERAPY, PLLC
Entity Type:Organization
Organization Name:HOME SPEECH THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED SLP
Authorized Official - Prefix:MS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:KAPAUN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:361-563-8460
Mailing Address - Street 1:16142 PIONCIANA ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6508
Mailing Address - Country:US
Mailing Address - Phone:361-563-8460
Mailing Address - Fax:361-949-3014
Practice Address - Street 1:16142 PIONCIANA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-6508
Practice Address - Country:US
Practice Address - Phone:361-563-8460
Practice Address - Fax:361-949-3014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102425235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty