1952539215 NPI number — SPEECH THERAPY SOLUTIONS, LLC

Table of content: (NPI 1952539215)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952539215 NPI number — SPEECH THERAPY SOLUTIONS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPEECH THERAPY SOLUTIONS, LLC
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:
1952539215
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
47 W RAILROAD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STANTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40380-2034
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-663-8008
Provider Business Mailing Address Fax Number:
606-663-0550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
47 W RAILROAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STANTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40380-2034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-663-8008
Provider Business Practice Location Address Fax Number:
606-663-0550
Provider Enumeration Date:
06/25/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SKEENS
Authorized Official First Name:
CHARLENE
Authorized Official Middle Name:
NICOLE
Authorized Official Title or Position:
SPEECH LANGUAGE PATHOLOGIST/OWNER
Authorized Official Telephone Number:
859-749-8977

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  3433 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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