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General NPI Number Information
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NPI Number | 1124807771
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Entity Type | Organization
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Legal Business Name | BOOKMARK SPEECH, LANGUAGE, & LITERACY SERVICES, PLLC.
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Dates
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Enumeration Date | 09/25/2023
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 5709 NE 130TH ST
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City | VANCOUVER
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State | WA
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Zip | 98686-4932
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Country | US
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Telephone | 360-602-1515
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Fax |
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Provider Business Mailing Address
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Address Line | 5709 NE 130TH ST
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City | VANCOUVER
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State | WA
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Zip | 98686-4932
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/SPEECH LANGUAGE PATHOLOGIST
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Name | AUDRIE BETH LUCZEK
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Credential | M.S. CCC-SLP
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Telephone | 360-602-1515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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