| Organization Name: | LIFESPAN ASSESSMENT SPEECH THERAPY SERVICES |
| NPI Number: | 1538421813 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KATHERINE ELIZABETH MOUTON (OWNER/ SPEECH-PATHOLOGIST) |
| Mailing Address: | 1544 Sawdust Rd Suite 105 The Woodlands |
| State: | TX US |
| Postal Code: | 773802929 |
| Phone Number: | 8327380507 |
| Fax Number: | 2817195962 |
| NPI Enumeration Date: | 06/12/2012 |
| NPI Last Update Date: | 06/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 12119234 |
| 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 |