Basic Information
| Provider Information | |||||||||
| NPI: | 1275003063 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANDERSON | ||||||||
| FirstName: | CLAIRE | ||||||||
| MiddleName: | ALYSSA | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8503 CANYON PINE DR | ||||||||
| Address2: | |||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773796335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2819610028 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2424 WILCREST DR STE 110 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770422772 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7136668287 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2018 | ||||||||
| LastUpdateDate: | 04/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 116219 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.