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Organization
TAG THERAPY INC
Active
Organization
TAG THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRANDA DODSON (OWNER)
(936) 681-0165
Entity
Organization
Contact information
Practice address
1422 E STARR AVE, NACOGDOCHES, TX 75961-4362
(936) 681-0165
Mailing address
1422 E STARR AVE, NACOGDOCHES, TX 75961-4362
(936) 681-0165
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
10/21/2021
Last updated
01/03/2024
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