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General NPI Number Information
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NPI Number | 1083080410
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Entity Type | Organization
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Legal Business Name | SPEAK LIFE SERVICES LLC
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Dates
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Enumeration Date | 08/20/2015
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Last Update Date | 08/20/2015
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Provider Practice Location Address
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Address Line | 10606 WARWICK BLVD STE B
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-3709
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Country | US
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Telephone | 757-927-3162
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Fax |
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Provider Business Mailing Address
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Address Line | 10606 WARWICK BLVD STE B
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-3709
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Country | US
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Telephone | 757-927-3162
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | CHRISTINE C COOPER
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Credential |
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Telephone | 757-927-3162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 2202006657
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 2202006657
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 2202006657
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License Number State | VA
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