Provider Demographics
NPI:1992422182
Name:AUREATE SPEECH THERAPY, LLC
Entity type:Organization
Organization Name:AUREATE SPEECH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLER
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:631-987-4623
Mailing Address - Street 1:10901 BRIGHTON BAY BLVD NE APT 4311
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-3452
Mailing Address - Country:US
Mailing Address - Phone:813-750-7852
Mailing Address - Fax:
Practice Address - Street 1:10901 BRIGHTON BAY BLVD NE APT 4311
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-3452
Practice Address - Country:US
Practice Address - Phone:813-750-7852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty