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General NPI Number Information
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NPI Number | 1558887810
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Entity Type | Organization
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Legal Business Name | SPEAK UP ONLINE SPEECH THERAPEUTICS LLC
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 08/18/2017
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Provider Practice Location Address
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Address Line | 86 FEATHER RIDGE RD
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City | MARQUETTE
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State | MI
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Zip | 49855-9427
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Country | US
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Telephone | 19062491509
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Fax |
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Provider Business Mailing Address
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Address Line | 86 FEATHER RIDGE RD
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City | MARQUETTE
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State | MI
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Zip | 49855-9427
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Country | US
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Telephone | 19062491509
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST/OWNER
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Name | CHRISTINE RICKE-VOSS
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Credential | MS, CCC-SLP
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Telephone | 906-249-1509
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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 | 7101003441
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License Number State | MI
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