Provider Demographics
NPI:1073287272
Name:ANDIE B. SPEECH THERAPY, LLC
Entity type:Organization
Organization Name:ANDIE B. SPEECH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STREET
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:985-981-1441
Mailing Address - Street 1:33761 JOHN BARBER RD
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:LA
Mailing Address - Zip Code:70744-3429
Mailing Address - Country:US
Mailing Address - Phone:985-981-1441
Mailing Address - Fax:
Practice Address - Street 1:33761 JOHN BARBER RD
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:LA
Practice Address - Zip Code:70744-3429
Practice Address - Country:US
Practice Address - Phone:985-981-1441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty