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General NPI Number Information
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NPI Number | 1649990847
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Entity Type | Organization
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Legal Business Name | HYDE & GO SPEAK
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Dates
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Enumeration Date | 08/30/2022
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 120 LITTLE WOOD RESERVOIR RD.
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City | CAREY
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State | ID
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Zip | 83320
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Country | US
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Telephone | 208-823-4587
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Fax | 208-823-4587
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Provider Business Mailing Address
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Address Line | PO BOX 262
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City | CAREY
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State | ID
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Zip | 83320-0262
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Country | US
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Telephone | 208-721-0086
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Fax | 208-823-4587
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MRS. STACEY MECHAM
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Credential | MSLP
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Telephone | 208-721-0086
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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 |
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License Number State |
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