Provider Demographics
NPI:1154945301
Name:PERCHEL LABS
Entity type:Organization
Organization Name:PERCHEL LABS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP-D
Authorized Official - Phone:618-306-0889
Mailing Address - Street 1:220 N HARLEM ST
Mailing Address - Street 2:
Mailing Address - City:EUDORA
Mailing Address - State:AR
Mailing Address - Zip Code:71640-2755
Mailing Address - Country:US
Mailing Address - Phone:618-306-0889
Mailing Address - Fax:870-355-4308
Practice Address - Street 1:220 N HARLEM ST
Practice Address - Street 2:
Practice Address - City:EUDORA
Practice Address - State:AR
Practice Address - Zip Code:71640-2755
Practice Address - Country:US
Practice Address - Phone:618-306-0889
Practice Address - Fax:870-355-4308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty