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General NPI Number Information
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NPI Number | 1457792095
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Entity Type | Organization
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Legal Business Name | REACH FOR SPEECH LLC
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Dates
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Enumeration Date | 07/11/2013
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 3399 BRODHEAD RD SUITE A
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City | ALIQUIPPA
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State | PA
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Zip | 15001-1261
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Country | US
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Telephone | 724-888-2548
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Fax | 724-888-2913
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Provider Business Mailing Address
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Address Line | 112 VALLEYVIEW AVE
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City | ALIQUIPPA
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State | PA
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Zip | 15001-4735
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Country | US
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Telephone | 724-888-2548
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | MS. DEBRA ANN WYGANT
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Credential | MA, CCC-SLP
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Telephone | 724-888-2548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | SL006251L
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License Number State | PA
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