Klc Pediatric Therapy, LLC
Speech-Language Pathologist, in Aledo, TX. Organization (NPI-2).
NPI number1306629142
StatusActive
Last updated in NPPESAug 17, 2023
Details
- NPI
- 1306629142
- Entity type
- Organization (NPI-2)
- Legal business name
- Klc Pediatric Therapy, LLC
- Organization subpart
- No
- Enumeration date
- Aug 16, 2023
- Certification date
- Aug 17, 2023
- Last updated
- Aug 17, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | – | – | Yes |
Practice location
1015 Champions Dr # 102Aledo, TX 76008-3206
Phone 214-803-1699
Mailing address
418 Prairie RunAledo, TX 76008-1170
Phone 214-803-1699
Other practice locations
701 Highway 352
Mesquite, TX 75149-6897
Mesquite, TX 75149-6897
Phone 214-803-1699
Authorized official
Jacey Bullock
Owner
2148031699
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