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General NPI Number Information
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NPI Number | 1366803686
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Entity Type | Organization
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Legal Business Name | VALLEY SPEECH-LANGUAGE PATHOLOGY, LLC
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Dates
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Enumeration Date | 03/14/2016
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Last Update Date | 03/14/2016
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Provider Practice Location Address
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Address Line | 409 PARK DR
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City | NEENAH
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State | WI
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Zip | 54956-2858
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Country | US
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Telephone | 920-944-8757
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Fax |
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Provider Business Mailing Address
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Address Line | 409 PARK DR
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City | NEENAH
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State | WI
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Zip | 54956-2858
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Country | US
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Telephone | 920-944-8757
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SARAH MARGARET ALLEN
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Credential | MS, CCC-SLP
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Telephone | 920-944-8757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA3000X
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Taxonomy Name | Augmentative Communication Clinic/Center
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License Number | 4252 - 154
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 4252 - 154
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License Number State | WI
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