Provider Demographics
NPI:1962144782
Name:EXEMPLARY SPEECH SERVICES
Entity type:Organization
Organization Name:EXEMPLARY SPEECH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ SLP
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:N
Authorized Official - Last Name:HEATOR-DIETSCHE
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:616-300-5495
Mailing Address - Street 1:2880 WILSON AVE SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49418-1221
Mailing Address - Country:US
Mailing Address - Phone:616-300-5495
Mailing Address - Fax:
Practice Address - Street 1:2880 WILSON AVE SW
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-1221
Practice Address - Country:US
Practice Address - Phone:616-300-5495
Practice Address - Fax:616-469-1464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty