Provider Demographics
NPI:1780082669
Name:ART OF SPEECH THERAPY CENTER
Entity type:Organization
Organization Name:ART OF SPEECH THERAPY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:832-446-6085
Mailing Address - Street 1:3845 CYPRESS CREEK PKWY
Mailing Address - Street 2:SUITE 283
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-3531
Mailing Address - Country:US
Mailing Address - Phone:832-446-6085
Mailing Address - Fax:832-446-3699
Practice Address - Street 1:3845 CYPRESS CREEK PKWY
Practice Address - Street 2:SUITE 283
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3531
Practice Address - Country:US
Practice Address - Phone:832-446-6085
Practice Address - Fax:832-446-3699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103594235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208435201Medicaid