Individual
MRS. ANDREA THAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
4650 S PANTHER CREEK DR, SPRING, TX 77381-2764
(716) 310-1556
Mailing address
4650 S PANTHER CREEK DR, SPRING, TX 77381-2764
(716) 310-1556
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
108436
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235Z00000X
—
TX
Enumeration date
03/09/2015
Last updated
03/09/2015
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