Provider Demographics
NPI:1093555328
Name:EPIPHANY SPEECH THERAPY, LLC
Entity type:Organization
Organization Name:EPIPHANY SPEECH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:KLINKHAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-690-7840
Mailing Address - Street 1:3405 6TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-4402
Mailing Address - Country:US
Mailing Address - Phone:605-690-7840
Mailing Address - Fax:
Practice Address - Street 1:3405 6TH ST STE 3
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-4402
Practice Address - Country:US
Practice Address - Phone:605-690-7840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty