Healthcare Provider Details

I. General information

NPI: 1538759717
Provider Name (Legal Business Name): SOUND SPEECH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2021
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 MESA WAY STE D
LAWRENCE KS
66049-2343
US

IV. Provider business mailing address

1621 BOB WHITE DR
LAWRENCE KS
66047-9305
US

V. Phone/Fax

Practice location:
  • Phone: 785-831-3053
  • Fax: 785-746-0132
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY WILLIAMS
Title or Position: SPEECH-LANGUAGE PATHOLOGY
Credential: MS CCC-SLP
Phone: 785-766-3217