Provider Demographics
NPI:1992769756
Name:THERAPEUTIC & EDUCATIONAL RESOURCES, LLC
Entity type:Organization
Organization Name:THERAPEUTIC & EDUCATIONAL RESOURCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:NORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MCD
Authorized Official - Phone:504-452-5766
Mailing Address - Street 1:3141 GOLFCREST DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-8984
Mailing Address - Country:US
Mailing Address - Phone:936-582-0274
Mailing Address - Fax:
Practice Address - Street 1:3141 GOLFCREST DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-8984
Practice Address - Country:US
Practice Address - Phone:936-582-0274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2012-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA21235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty