Individual
MRS. THERESA BACALA JAVIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC SLP
Contact information
Practice address
601 S FLOYD ST, STE 500, LOUISVILLE, KY 40202-1835
(502) 588-0329
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0329
(502) 588-0326
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22003679A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200730660A
INDIANA FIRST STEPS
IN
Enumeration date
03/18/2007
Last updated
06/19/2015
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