Provider Demographics
NPI:1285768119
Name:SPEECH LANGUAGE & STUTTERING THERAPY INC
Entity type:Organization
Organization Name:SPEECH LANGUAGE & STUTTERING THERAPY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCCSLP
Authorized Official - Phone:225-930-0208
Mailing Address - Street 1:768 CHEVELLE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6503
Mailing Address - Country:US
Mailing Address - Phone:225-930-0208
Mailing Address - Fax:225-930-0221
Practice Address - Street 1:768 CHEVELLE DRIVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806
Practice Address - Country:US
Practice Address - Phone:225-930-0208
Practice Address - Fax:225-930-0221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty