Organization
COMMONWEALTH THERAPY COMPANY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAUREEN O'DOHERTY DI VINCENZO SLP (SLP/PRESIDENT)
(541) 771-0163
Entity
Organization
Contact information
Practice address
820 S. MACARTHUR BLVD STE 105 - 149, COPPELL, TX 75019-1171
(703) 718-6603
Mailing address
428 WELLINGTON RD, COPPELL, TX 75019-6705
(703) 718-6603
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
02/26/2019
Last updated
08/12/2024
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