1881120327 NPI number — SPEECH SAVVY, PLLC

Table of content: TAMI ANN BREUER GANGESTAD MS, RDN, CNSC, LN (NPI 1174169197)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881120327 NPI number — SPEECH SAVVY, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPEECH SAVVY, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881120327
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/03/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 KENSINGTON AVE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
MISSOULA
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59801-5674
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-531-1893
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 KENSINGTON AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
MISSOULA
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59801-5674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-531-1893
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/03/2017

Additional Information

Authorized Official

Authorized Official Last Name:
MCELMURRY
Authorized Official First Name:
KRISTINE
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
SPEECH LANGUAGE PATHOLOGIST
Authorized Official Telephone Number:
406-531-1893

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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