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General NPI Number Information
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NPI Number | 1336880988
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Entity Type | Organization
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Legal Business Name | TALK OF THE TOWN SLP L.L.C
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Dates
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Enumeration Date | 04/06/2022
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Last Update Date | 04/06/2022
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Provider Practice Location Address
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Address Line | 79 N HOWARD AVE STE B
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City | CROSWELL
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State | MI
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Zip | 48422-1222
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Country | US
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Telephone | 810-334-1090
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Fax |
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Provider Business Mailing Address
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Address Line | 79 N HOWARD AVE STE B
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City | CROSWELL
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State | MI
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Zip | 48422-1222
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Country | US
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Telephone | 810-334-1090
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GREGORY MASON
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Credential | M.A. CCC-SLP
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Telephone | 810-334-1090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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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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