Provider Demographics
NPI:1396493193
Name:SOUND SPEECH PATHOLOGY, LLC
Entity type:Organization
Organization Name:SOUND SPEECH PATHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:M ED, CCC-SLP
Authorized Official - Phone:360-375-4300
Mailing Address - Street 1:9838 SE CORNELL RD
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-8955
Mailing Address - Country:US
Mailing Address - Phone:360-375-4300
Mailing Address - Fax:360-824-6838
Practice Address - Street 1:2497 BETHEL RD SE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-2489
Practice Address - Country:US
Practice Address - Phone:360-375-4300
Practice Address - Fax:360-824-6838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty