Provider Demographics
NPI:1548680739
Name:TALK & PLAY SPEECH TX, LLC
Entity type:Organization
Organization Name:TALK & PLAY SPEECH TX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFOSO RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:786-470-5453
Mailing Address - Street 1:2500 NW 79TH AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1003
Mailing Address - Country:US
Mailing Address - Phone:786-483-8332
Mailing Address - Fax:786-483-8466
Practice Address - Street 1:2500 NW 79TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1003
Practice Address - Country:US
Practice Address - Phone:786-483-8332
Practice Address - Fax:786-483-8466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-26
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty