Provider Demographics
NPI:1144785924
Name:BOCALINGUAL SPEECH THERAPY LLC
Entity type:Organization
Organization Name:BOCALINGUAL SPEECH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ANDON
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:210-608-9220
Mailing Address - Street 1:902 KITTY HAWK RD STE 170-450
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-3825
Mailing Address - Country:US
Mailing Address - Phone:210-608-9220
Mailing Address - Fax:210-695-7028
Practice Address - Street 1:902 KITTY HAWK RD STE 170-450
Practice Address - Street 2:
Practice Address - City:UNIVERSAL CITY
Practice Address - State:TX
Practice Address - Zip Code:78148-3825
Practice Address - Country:US
Practice Address - Phone:210-608-9220
Practice Address - Fax:210-695-7028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty