Provider Demographics
NPI:1215137724
Name:KIDS TALK LLC
Entity type:Organization
Organization Name:KIDS TALK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:DODSON
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MS-CCC-SLP
Authorized Official - Phone:727-724-5437
Mailing Address - Street 1:2759 SR 580
Mailing Address - Street 2:STE 112
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761
Mailing Address - Country:US
Mailing Address - Phone:727-724-5437
Mailing Address - Fax:813-435-2125
Practice Address - Street 1:2759 SR 580
Practice Address - Street 2:STE 112
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3352
Practice Address - Country:US
Practice Address - Phone:727-724-5437
Practice Address - Fax:813-435-2125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 320235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty