Provider Demographics
NPI:1104589548
Name:SCHOOL OF TALK PEDIATRIC THERAPIES, L.L.C.
Entity type:Organization
Organization Name:SCHOOL OF TALK PEDIATRIC THERAPIES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SLP
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:502-494-2437
Mailing Address - Street 1:15224 CHESTNUT RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-5300
Mailing Address - Country:US
Mailing Address - Phone:502-494-2437
Mailing Address - Fax:
Practice Address - Street 1:11802 BRINLEY AVE STE 101
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1089
Practice Address - Country:US
Practice Address - Phone:502-494-2437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100387140Medicaid