Provider Demographics
NPI:1588257257
Name:SPECTRUM SPEECH THERAPY
Entity type:Organization
Organization Name:SPECTRUM SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:SCHUELER
Authorized Official - Suffix:
Authorized Official - Credentials:MSCCC-SLP
Authorized Official - Phone:443-875-7606
Mailing Address - Street 1:16060 YEOHO RD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9529
Mailing Address - Country:US
Mailing Address - Phone:443-875-7606
Mailing Address - Fax:
Practice Address - Street 1:16060 YEOHO RD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:MD
Practice Address - Zip Code:21152-9529
Practice Address - Country:US
Practice Address - Phone:443-875-7606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-14
Last Update Date:2021-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech