Provider Demographics
NPI:1285174235
Name:MAUI CHATTERBOX SPEECH THERAPY L.L.C.
Entity type:Organization
Organization Name:MAUI CHATTERBOX SPEECH THERAPY L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:FAITH
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:808-359-4762
Mailing Address - Street 1:2747 S KIHEI RD
Mailing Address - Street 2:H205
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-9619
Mailing Address - Country:US
Mailing Address - Phone:808-359-4762
Mailing Address - Fax:808-419-6501
Practice Address - Street 1:2747 S KIHEI RD
Practice Address - Street 2:H205
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-9619
Practice Address - Country:US
Practice Address - Phone:808-359-4762
Practice Address - Fax:808-419-6501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2017-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HISP-1229235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty