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General NPI Number Information
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NPI Number | 1750065660
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Entity Type | Organization
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Legal Business Name | SPEAK UP THERAPY SOLUTIONS, PLLC
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Dates
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Enumeration Date | 06/12/2023
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Last Update Date | 05/01/2024
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Provider Practice Location Address
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Address Line | 524 W STEPHENSON ST STE 211
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City | FREEPORT
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State | IL
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Zip | 61032-5058
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Country | US
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Telephone | 815-990-0801
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Fax |
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Provider Business Mailing Address
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Address Line | 1245 LACRESTA DR
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City | FREEPORT
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State | IL
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Zip | 61032-6161
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Country | US
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Telephone | 815-990-0801
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Fax |
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Authorized Official
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Title or Position | OWNER/SPEECH LANGUAGE PATHOLOGIST
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Name | STACEY HICKS
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Credential | M.S. CCC-SLP/L
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Telephone | 815-990-0801
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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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