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General NPI Number Information
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NPI Number | 1497039580
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Entity Type | Organization
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Legal Business Name | SPEAK UP LLC
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 216 HOGAN ST
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City | BERWICK
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State | LA
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Zip | 70342-2006
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Country | US
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Telephone | 985-518-3834
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Fax |
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Provider Business Mailing Address
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Address Line | 216 HOGAN ST
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City | BERWICK
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State | LA
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Zip | 70342-2006
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Country | US
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Telephone | 985-518-3834
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGAUGE PATHOLOGIST
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Name | LAUREN LEBLANC MONTGOMERY
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Credential | MS CCC-SLP
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Telephone | 985-518-3834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State | LA
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