NPI | 1518565936 |
---|---|
Former Legal Business Name | FOX THERAPIES, LLC |
Entity Type | Organization |
Authorized Contact | LAISLEE S VAN ETTEN Slp/Owner 512-542-1265 |
Organization Subpart ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
251S00000X | |
Enumeration Date | 2020-10-16 |
Last Update Date | 2020-10-16 |