Wilkinson Broden Therapy Innovations, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1842 Issued in TX

Legal business name

WILKINSON BRODEN THERAPY INNOVATIONS, LLC

Practice address

1118 The Meadows Pkwy
Desoto, TX 75115-3518

Phone

(214) 687-8850

NPI assigned

Nov 1, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Donna Wilkinson Broden, M.A., CCC-SLP

Title

Owner

Phone

(214) 392-5776

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351728000000",
    "number": "1427302207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 THE MEADOWS PKWY",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751153518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 THE MEADOWS PKWY",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751153518",
            "telephone_number": "214-687-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILKINSON BRODEN THERAPY INNOVATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-01",
        "last_updated": "2012-11-01",
        "status": "A",
        "authorized_official_last_name": "BRODEN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "WILKINSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-392-5776",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.A., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "1842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Desoto, TX
• Providers in Desoto, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.