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Organization
MI CASA SPEECH AND LANGUAGE THERAPY
Active
Organization
MI CASA SPEECH AND LANGUAGE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY ANNE NERICCIO PHD (OWNER)
(512) 909-1684
Entity
Organization
Contact information
Practice address
2509 TOULOUSE DR, AUSTIN, TX 78748-6049
(512) 909-1684
Mailing address
2509 TOULOUSE DR, AUSTIN, TX 78748-6049
(512) 909-1684
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10310
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376668863
PERSONAL NPI
TX
Enumeration date
07/21/2010
Last updated
07/21/2010
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