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Individual

CAROL EKSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
500 BLANCO ST, KYLE, TX 78640-8012
(512) 268-4688
Mailing address
4130 MATHER, KYLE, TX 78640-9208
(860) 752-8508

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
114820
TX

Other

Enumeration date
09/01/2021
Last updated
09/01/2021
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