Organization Name: | WACO SPEAKS LLC |
NPI Number: | 1497171086 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KELLI H IRWIN (SPEECH PATHOLOGIST) |
Mailing Address: | 925 Cheyenne Trl Hewitt |
State: | TX US |
Postal Code: | 766433288 |
Phone Number: | 7068479287 |
Fax Number: | |
NPI Enumeration Date: | 03/06/2014 |
NPI Last Update Date: | 03/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 105491 |
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 |