Healthcare Provider Details
I. General information
NPI: 1528990660
Provider Name (Legal Business Name): PRECIOUS PEARL SPEECH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3549 BRISTOW RD
BRISTOW IN
47515-9045
US
IV. Provider business mailing address
3549 BRISTOW RD
BRISTOW IN
47515-9045
US
V. Phone/Fax
- Phone: 812-499-9816
- Fax:
- Phone: 812-499-9816
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SYDNEY
TAYLOR
Title or Position: SLP
Credential: M.S., CCC-SLP
Phone: 812-499-9816