Provider Demographics
NPI:1215651104
Name:LEVINE SPEECH THERAPY
Entity type:Organization
Organization Name:LEVINE SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:541-944-8886
Mailing Address - Street 1:2305 ASHLAND ST # 104-461
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3777
Mailing Address - Country:US
Mailing Address - Phone:541-944-8886
Mailing Address - Fax:
Practice Address - Street 1:850 SISKIYOU BLVD STE 9
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-2125
Practice Address - Country:US
Practice Address - Phone:541-204-1886
Practice Address - Fax:541-702-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty