Provider Demographics
NPI:1306542931
Name:CHASING UNICORNS PEDIATRIC SPEECH LANGUAGE & FEEDING, LLC
Entity type:Organization
Organization Name:CHASING UNICORNS PEDIATRIC SPEECH LANGUAGE & FEEDING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:CHRISTIME
Authorized Official - Last Name:COVEN-ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:734-657-8949
Mailing Address - Street 1:19689 7TH AVE NE # 270
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8091
Mailing Address - Country:US
Mailing Address - Phone:360-450-3345
Mailing Address - Fax:360-979-1572
Practice Address - Street 1:1430 NW HERMIT RIDGE LN
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7116
Practice Address - Country:US
Practice Address - Phone:360-450-3345
Practice Address - Fax:360-979-1572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty