Healthcare Provider Details

I. General information

NPI: 1033074372
Provider Name (Legal Business Name): SPEAK LIFE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 COUNTRY CLUB DR
NEWTON KS
67114-4550
US

IV. Provider business mailing address

715 COUNTRY CLUB DR
NEWTON KS
67114-4550
US

V. Phone/Fax

Practice location:
  • Phone: 620-386-4791
  • Fax:
Mailing address:
  • Phone: 620-386-4791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: LAUREN ELIZABETH CAMPBELL
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M.A. SLP
Phone: 620-386-4791