Provider Demographics
NPI:1124876107
Name:SPEECH 101 THERAPY INC
Entity type:Organization
Organization Name:SPEECH 101 THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAUN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SKYRM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-256-0533
Mailing Address - Street 1:15459 SW 92ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1125
Mailing Address - Country:US
Mailing Address - Phone:330-256-0533
Mailing Address - Fax:330-595-4727
Practice Address - Street 1:15459 SW 92ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1125
Practice Address - Country:US
Practice Address - Phone:330-256-0533
Practice Address - Fax:330-595-4727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty