Provider Demographics
NPI:1316448012
Name:FREE YOUR SPEECH
Entity type:Organization
Organization Name:FREE YOUR SPEECH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SENTA
Authorized Official - Middle Name:
Authorized Official - Last Name:EMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP/L
Authorized Official - Phone:708-869-0192
Mailing Address - Street 1:2435 DAVISSON ST
Mailing Address - Street 2:
Mailing Address - City:RIVER GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60171-1716
Mailing Address - Country:US
Mailing Address - Phone:630-234-1092
Mailing Address - Fax:
Practice Address - Street 1:2435 DAVISSON ST
Practice Address - Street 2:
Practice Address - City:RIVER GROVE
Practice Address - State:IL
Practice Address - Zip Code:60171-1716
Practice Address - Country:US
Practice Address - Phone:630-234-1092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146010961235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty