Olive Branch Autism Clinic and Therapy Services LLC

NPI #1285136622 in Katy, Texas

Provider Information

NPI Number: 1285136622
Entity Type: Organization
Organization Name: Olive Branch Autism Clinic and Therapy Services LLC
Primary Specialty: Clinic/Center - Hearing and Speech
Enumeration Date: Mar 1, 2018
Last Updated: Mar 8, 2019

Practice Location

Address: 2526 KINSGATE FOREST DR
City: Katy
State: Texas
ZIP Code: 77494-1898
Phone: (832) 557-0579

Authorized Official

Name: SHAWNA MARIE NICKERSON, M.A., CCC-SLP
Title: SPEECH LANGUAGE PATHOLOGIST
Phone: (770) 630-6753

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Hearing and Speech — Hearing and Speech	261QH0700X	Primary

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