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General NPI Number Information
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NPI Number | 1588016745
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Entity Type | Organization
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Legal Business Name | THERAPY SQUAD LLC
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Dates
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Enumeration Date | 07/11/2016
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Last Update Date | 07/11/2016
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Provider Practice Location Address
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Address Line | 399 LAREDO DR
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City | HOOVER
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State | AL
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Zip | 35226-2367
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Country | US
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Telephone | 205-820-0303
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Fax | 205-419-2966
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Provider Business Mailing Address
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Address Line | 399 LAREDO DR
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City | HOOVER
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State | AL
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Zip | 35226-2367
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Country | US
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Telephone |
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Fax | 205-419-2966
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABTH BURKLOW
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Credential | MA CCC-SLP
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Telephone | 205-820-0303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 3814
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License Number State | AL
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