Healthcare Provider Details

I. General information

NPI: 1386292605
Provider Name (Legal Business Name): DOUBLE TALK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 02/19/2024
Certification Date: 12/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 REDTAIL RD SUITE 12A
ORCHARD PARK NY
14127
US

IV. Provider business mailing address

240 REDTAIL RD SUITE 12A
ORCHARD PARK NY
14127
US

V. Phone/Fax

Practice location:
  • Phone: 716-608-2988
  • Fax: 716-608-2942
Mailing address:
  • Phone: 716-608-2988
  • Fax: 716-608-2942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: KRISTA HAMMER
Title or Position: OWNER
Credential: MS, CCC-SLP
Phone: 716-608-2988