Neeley Anderson

Individual provider Active NPI Speech-Language Pathologist · Texarkana, TX

NPI 1962855015 · NPPES record last updated Mar 14, 2018

Key facts

NPI
1962855015
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
113353 (TX)
Practice address
4824 McKnight Rd
Texarkana, TX 75503-0935
Phone
(903) 793-6135
Fax
(903) 793-0053
NPI assigned
Jul 13, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
113353TXMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist
Group: 193400000X SINGLE SPECIALTY GROUP
235Z00000X 113353 TX Yes

Addresses

Primary practice location

4824 McKnight Rd
Texarkana, TX 75503-0935

Mailing address

4824 McKnight Rd
Texarkana, TX 75503-0935
Phone (903) 793-6135

Other identifiers

IdentifierTypeStateIssuer
113353OtherTXSPEECH LANGUAGE PATHOLOGIST LICENSE

Other providers in Texarkana, TX

All providers in Texarkana, TX · Speech-Language Pathologist in Texas

Sources for this page

Verify at the official NPI Registry.