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General NPI Number Information
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NPI Number | 1437871225
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Entity Type | Organization
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Legal Business Name | A SPEECH STORY
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 110 N WILLOW ST
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City | KENAI
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State | AK
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Zip | 99611-7797
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Country | US
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Telephone | 907-215-3785
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Fax | 907-215-3780
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Provider Business Mailing Address
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Address Line | 49780 EIDER DR
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City | KENAI
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State | AK
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Zip | 99611-6470
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Country | US
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Telephone | 907-215-3785
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Fax | 907-215-3780
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA DUKE
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Credential | CCC-SLP
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Telephone | 907-215-3715
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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 |
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License Number State |
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