EVOLUTION PEDIATRIC THERAPY, LLC (NPI# 1215421268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215421268 |
| Entity Type | Organization |
| Organization Name | EVOLUTION PEDIATRIC THERAPY, LLC |
| Practice Address |
1620 Birch Grove Trl Keller TX 76248-9732 |
| Practice Telephone | 2143923138 |
| Mailing Telephone | 2143923138 |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2018-06-21 |
| Authorized Official Name | KELDRA WARREN (OWNER/SPEECH-LANGUAGE PATHOLOGIST A) |
| Authorized Official Telephone | 2143923138 |
| Authorized Official Credential | SLPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers |
| Street Address |
1620 BIRCH GROVE TRL |
| City | KELLER |
| State | TX |
| Zip Code | 76248-9732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316556145 | Tyler Woodall | Counselor | 1668 Keller Parkway, Suite 200, Keller, TX 76248 | 2020-07-28 |
| 1396366456 | Kelcie Dao | Speech-Language Pathologist | 630 B Stoneglen Drive, Keller, TX 76248 | 2020-04-29 |
| 1003447384 | Alliance Orthotics and Prosthetics, L.L.C. | Prosthetic/Orthotic Supplier | 101 Bourland Rd Suite A, Keller, TX 76248 | 2020-01-27 |
| 1033759832 | Everest Rehabilitation Hospital Keller, LLC | Rehabilitation Hospital | 955 S. Main St., Keller, TX 76248 | 2020-01-09 |
| 1750934253 | Pediatric Dentistry of Keller Pllc | Dentist | 1627 Keller Parkway, Suite 100, Keller, TX 76248 | 2019-07-23 |
| 1306345293 | Jaqui Otto | Psychologist | 1664 Keller Parkway Ste 102, Keller, TX 76248 | 2018-02-06 |
| 1194223404 | Hartman Samuel Ian Watson | Chiropractor | 1211 S Main St Ste 300h, Keller, TX 76248 | 2018-02-01 |
| 1760900997 | Md First Watch Healthcare Pllc | Clinic/Center | 310 Keller Parkway, Keller, TX 76248 | 2017-09-08 |
| 1588104541 | Elias Alharari | Nurse Practitioner | 651 S Main St Ste 102, Keller, TX 76248 | 2017-02-24 |
| 1730631698 | Alliance Counseling and Education Center | Social Worker | 1540 Keller Parkway, Ste. 108-205, Keller, TX 76248 | 2016-10-26 |
| Find all providers in zip 76248 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396366456 | Kelcie Dao | Speech-Language Pathologist | 630 B Stoneglen Drive, Keller, TX 76248 | 2020-04-29 |
| 1295246817 | Allison N Mills | Speech-Language Pathologist | 630 Stoneglen Dr Ste B, Keller, TX 76248-3626 | 2017-10-23 |
| 1770032484 | Lydia Baldwin | Speech-Language Pathologist | 1837 Windsong Cir, Keller, TX 76248-7303 | 2016-09-23 |
| 1619224607 | Paula J. Boerman | Speech-Language Pathologist | 1520 Birchmont Ln, Keller, TX 76248-8209 | 2012-08-08 |
| 1548547722 | Catherine R. Moore | Speech-Language Pathologist | 408 Durrand Oak Dr, Keller, TX 76248-5640 | 2011-11-15 |
| 1588943906 | Tracy Lynn Pahl | Speech-Language Pathologist | 306 Longview Dr, Keller, TX 76248-7321 | 2011-08-16 |
| 1275864597 | Julie Beth Heindselman | Speech-Language Pathologist | 2304 Ember Woods Dr, Keller, TX 76262-8824 | 2010-01-26 |
| 1508096678 | Sandra Lee Garcia | Speech-Language Pathologist | 8948 Riscky Trl, Keller, TX 76248-6122 | 2009-07-22 |
| 1518101575 | Chantal Scott | Speech-Language Pathologist | 3509 Aldersyde Dr, Keller, TX 76248-9581 | 2009-04-21 |
| 1447474309 | Jennifer Mcreynolds | Speech-Language Pathologist | 4701 Eagle Trace Dr, Keller, TX 76248-7960 | 2007-04-12 |
| Find all providers in KELLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.