Organization Name: | BEYOND SPEECH THERAPY , PLLC |
NPI Number: | 1659745446 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRENDA GILLAR (SPEECH LANGUAGE PATHOLOGIST) |
Mailing Address: | 1809 W Loop 281 Ste100 Pmb153 Longview |
State: | TX US |
Postal Code: | 756042571 |
Phone Number: | 9033093816 |
Fax Number: | 8448626340 |
NPI Enumeration Date: | 11/17/2015 |
NPI Last Update Date: | 11/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 111907 |
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 |