Organization
HORIZONS PEDIATRIC THERAPY PLLC
Active
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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