Healthcare Provider Details
I. General information
NPI: 1871230649
Provider Name (Legal Business Name): THE SPEECH LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/13/2022
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 S WASHINGTON ST
MEXICO MO
65265-2730
US
IV. Provider business mailing address
101 S WASHINGTON ST
MEXICO MO
65265-2730
US
V. Phone/Fax
- Phone: 573-473-2394
- Fax: 573-519-5307
- Phone: 573-890-5029
- Fax: 573-519-5307
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2355S0801X |
| Taxonomy | Speech-Language Assistant |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LOREN
LITTRELL FINCK
Title or Position: OWNER/SLP
Credential:
Phone: 573-473-2394