Provider Demographics
NPI: | 1225117666 |
---|---|
Name: | SPEECH CONNECTIONS LLC |
Entity type: | Organization |
Organization Name: | SPEECH CONNECTIONS LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER, SPEECH PATHOLOGIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SUZETTE |
Authorized Official - Middle Name: | M |
Authorized Official - Last Name: | FREEMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MCD, CCC-SLP |
Authorized Official - Phone: | 803-767-5153 |
Mailing Address - Street 1: | 420 PAT RD |
Mailing Address - Street 2: | |
Mailing Address - City: | LEXINGTON |
Mailing Address - State: | SC |
Mailing Address - Zip Code: | 29073-8435 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 803-767-5153 |
Mailing Address - Fax: | 803-955-0972 |
Practice Address - Street 1: | 420 PAT RD |
Practice Address - Street 2: | |
Practice Address - City: | LEXINGTON |
Practice Address - State: | SC |
Practice Address - Zip Code: | 29073-8435 |
Practice Address - Country: | US |
Practice Address - Phone: | 803-767-5153 |
Practice Address - Fax: | 803-955-0972 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-11-05 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
224Z00000X, 225100000X, 2251P0200X, 225200000X, 225X00000X, 225XP0200X, 2355S0801X | ||
SC | 3579 | 235Z00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Not Answered | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
Not Answered | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
Not Answered | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
Not Answered | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
Not Answered | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
Not Answered | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
Not Answered | 2355S0801X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant | Group - Multi-Specialty |
Not Answered | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |