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General NPI Number Information
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NPI Number | 1407103443
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Entity Type | Organization
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Legal Business Name | SPEECH THERAPY UNLIMITED HALLELUJAH, LLC
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 4646 HILRY HUCKABY DR
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City | SHREVEPORT
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State | LA
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Zip | 71107-5707
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Country | US
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Telephone | 318-670-9710
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Fax | 318-227-9142
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Provider Business Mailing Address
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Address Line | 5609 CROSS TIMBERS DR
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City | SHREVEPORT
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State | LA
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Zip | 71129-3605
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Country | US
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Telephone | 318-670-9710
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Fax | 318-227-9142
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Authorized Official
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Title or Position | OWNER/CEO
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Name | BARBARA KING
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Credential | M.S., CCC-SLP
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Telephone | 318-670-9710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 1580
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License Number State | LA
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