Doctor Name: | JEAN MARIE DESALLE |
NPI Number: | 1134349780 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC-SLP |
License Number: | 10190 |
Business Practice Address: | 1007 S Ann Blvd Harker Heights, TX - 765481254 |
Business Phone Number: | 2546992090 |
Business Fax Number: | 2546997293 |
Mailing Address: | 618 N Main St, TEMPLE |
State: | TX |
Postal Code: | 765013249 |
Phone Number: | 2547736787 |
Fax Number: | 2547700516 |
NPI Enumeration Date: | 04/26/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 10190 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |