Provider Demographics
NPI:1548820665
Name:UNIQUE THERAPY SPEECH LANGUAGE LLC
Entity type:Organization
Organization Name:UNIQUE THERAPY SPEECH LANGUAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST /OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:281-798-6775
Mailing Address - Street 1:6606 FM 1488 RD STE 148-668
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-2544
Mailing Address - Country:US
Mailing Address - Phone:281-798-6775
Mailing Address - Fax:
Practice Address - Street 1:6606 FM 1488 RD STE 148-668
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-2544
Practice Address - Country:US
Practice Address - Phone:281-798-6775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110483OtherPRIVATE INSURANCE