MEDICARE: SPEAK EASY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	845	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881026961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEAK EASY

Provider Business Mailing Address
First Line	:	PO BOX 7940
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87194-7940
Country	:	US
Telephone Number	:	505-269-0677
Fax Number	:	505-243-0492

Provider Business Practice Location Address
First Line	:	901 RIO GRANDE BLVD NW
Second Line	:	SUITE F-146
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87104-2057
Country	:	US
Telephone Number	:	505-269-0677
Fax Number	:	505-243-0492

Authorized Official
Title or Position	:	OWNER
Name	:	ELIZABETH BRAUGHT
Credential	:	MS, CCC-SLP
Telephone Number	:	505-269-0677

Provider Enumeration Date	:	07/31/2013
Last Update Date	:	08/17/2016

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Directions to “SPEAK EASY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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