Provider Demographics
NPI:1336857440
Name:SPEECH AND SWALLOWING THERAPY, PLLC
Entity type:Organization
Organization Name:SPEECH AND SWALLOWING THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MS CCC-SLP
Authorized Official - Prefix:
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:NALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-673-8291
Mailing Address - Street 1:5445 LEXINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657-5964
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5445 LEXINGTON CIR
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:TX
Practice Address - Zip Code:77657-5964
Practice Address - Country:US
Practice Address - Phone:409-673-8291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty