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General NPI Number Information
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NPI Number | 1134640329
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Entity Type | Organization
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Legal Business Name | TAKE HOME SPEECH LLC
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 37397 CETACEA LN
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City | KENAI
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State | AK
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Zip | 99611-8778
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Country | US
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Telephone | 907-395-0348
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Fax | 844-548-5674
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Provider Business Mailing Address
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Address Line | 37397 CETACEA LN
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City | KENAI
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State | AK
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Zip | 99611-8778
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Country | US
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Telephone | 907-395-0348
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Fax | 844-548-5674
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Authorized Official
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Title or Position | SOLE MBR
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Name | CARMA GRACE SHAY
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Credential | MS
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Telephone | 907-395-0348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 530
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License Number State | AK
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