Doctor Name: | MRS. RUTH ROMA BERG |
NPI Number: | 1477608495 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BA |
License Number: | 10625 |
Business Practice Address: | 704 Longmire Road Suite 101 Beyond Boundaries Therapy Center Conroe, TX - 77304 |
Business Phone Number: | 9364412500 |
Business Fax Number: | |
Mailing Address: | 610 Northwood Drive, CONROE |
State: | TX |
Postal Code: | 77303 |
Phone Number: | 9365394640 |
Fax Number: | 9365391505 |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 10625 |
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 |