=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174478143
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPEECHERIE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2026
-----------------------------------------------------
Last Update Date | 03/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4108 MAIN ST STE C
-----------------------------------------------------
City | ERIE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16511-1968
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-323-9671
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 105 WELLINGTON ST
-----------------------------------------------------
City | NORTH EAST
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16428-1713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-323-9671
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | ABIGAIL REILLY-ECKSTROM
-----------------------------------------------------
Credential | MA CCC-SLP
-----------------------------------------------------
Telephone | 814-323-9671
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------