Organization
HORIZONS PEDIATRIC THERAPY PLLC
Active
Other names
Mobile Speech Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TARA NICOLE TROTT M.S, CCC-SLP (PROVIDER)
(512) 884-0175
Entity
Organization
Contact information
Practice address
109 CARLINA LOOP, LIBERTY HILL, TX 78642-0025
(346) 531-9448
(512) 988-5459
Mailing address
109 CARLINA LOOP, LIBERTY HILL, TX 78642-0025
(512) 884-0175
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
1744G0900X
Graphics Designer
—
—
174H00000X
Health Educator
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QA3000X
Augmentative Communication Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QH0700X
Hearing and Speech Clinic/Center
110687
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09894354
STATE OF TEXAS DRIVERS LICENSE
TX
01
—
110687
STATE OF TEXAS SLP LICENSE
TX
01
—
13562404
CAQH
—
01
—
14056
STATE OF ARIZONA SLP LICENSE
AZ
01
—
14101180
ASHA CERTIFICATION NUMBER
—
01
—
1780824680
INDIVIDUAL NPI NUMBER
—
05
—
1Z0625
—
TX
Enumeration date
03/26/2014
Last updated
11/22/2023
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