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Organization
SMILE N GROW REHAB LLC
Active
Organization
SMILE N GROW REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY ALVIZO (ADMINISTRATOR)
(956) 461-3411
Entity
Organization
Contact information
Practice address
605 N MAIN ST, SUITE D, DONNA, TX 78537-2725
(956) 461-3411
(956) 461-3416
Mailing address
605 N MAIN ST, SUITE D, DONNA, TX 78537-2725
(956) 461-3411
(956) 461-3416
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195485106
—
TX
05
—
207596202
—
TX
Enumeration date
04/09/2012
Last updated
04/09/2012
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