Healthcare Provider Details

I. General information

NPI: 1861328510
Provider Name (Legal Business Name): TOTALLY HEARD SPEECH THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 FRONT ST # 406
PERRYVILLE MD
21903-2752
US

IV. Provider business mailing address

PO BOX 637
PERRYVILLE MD
21903-0637
US

V. Phone/Fax

Practice location:
  • Phone: 719-299-6193
  • Fax:
Mailing address:
  • Phone: 719-299-6193
  • 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: NIKKI LOPEZ
Title or Position: SLP
Credential: MS, CCC-SLP
Phone: 719-299-6193