Provider Demographics
NPI:1568218519
Name:BIG SPRING SPEECH THERAPY
Entity type:Organization
Organization Name:BIG SPRING SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GORZYCKI
Authorized Official - Suffix:
Authorized Official - Credentials:SLP-CCC
Authorized Official - Phone:540-553-6526
Mailing Address - Street 1:1744 BIG SPRING DR
Mailing Address - Street 2:
Mailing Address - City:ELLISTON
Mailing Address - State:VA
Mailing Address - Zip Code:24087-3536
Mailing Address - Country:US
Mailing Address - Phone:540-553-6526
Mailing Address - Fax:
Practice Address - Street 1:1744 BIG SPRING DR
Practice Address - Street 2:
Practice Address - City:ELLISTON
Practice Address - State:VA
Practice Address - Zip Code:24087-3536
Practice Address - Country:US
Practice Address - Phone:540-553-6526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)