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General NPI Number Information
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NPI Number | 1003595554
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Entity Type | Organization
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Legal Business Name | SPEAK OUT SERVICES, LLC
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 826 A ST
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City | SPRINGFIELD
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State | OR
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Zip | 97477-4766
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Country | US
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Telephone | 402-740-7647
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Fax |
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Provider Business Mailing Address
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Address Line | 826 A ST
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City | SPRINGFIELD
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State | OR
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Zip | 97477-4766
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Country | US
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Telephone | 541-357-5051
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Fax | 608-291-7050
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | CORTNEY BRUMMOND
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Credential | M.S. CCC-SLP
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Telephone | 402-740-7647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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