Organization
THERAPY KORNER PEDIATRIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MODESTA TREVINO (SLP ASSISTANT)
(956) 445-3796
Entity
Organization
Contact information
Practice address
414 W. MAIN AVE., MISSION, TX 78574
(956) 445-3796
Mailing address
414 W. MAIN AVE., MISSION, TX 78574
(956) 445-3796
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
—
—
2355S0801X
Speech-Language Assistant
Primary
33532
TX
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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