Provider Demographics
NPI:1780404202
Name:SPEECH FOUNDATIONS PLLC
Entity type:Organization
Organization Name:SPEECH FOUNDATIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:832-693-1307
Mailing Address - Street 1:1323 COUNTY ROAD 92
Mailing Address - Street 2:
Mailing Address - City:CAT SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:78933-5499
Mailing Address - Country:US
Mailing Address - Phone:979-217-1813
Mailing Address - Fax:
Practice Address - Street 1:1323 COUNTY ROAD 92
Practice Address - Street 2:
Practice Address - City:CAT SPRING
Practice Address - State:TX
Practice Address - Zip Code:78933-5499
Practice Address - Country:US
Practice Address - Phone:979-217-1813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty