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General NPI Number Information
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NPI Number | 1770930356
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Entity Type | Organization
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Legal Business Name | EAZY SPEECH, LLC
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 05/24/2016
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Provider Practice Location Address
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Address Line | 4205 LAKEVIEW DR
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City | TEMPLE HILLS
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State | MD
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Zip | 20748-4934
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Country | US
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Telephone | 301-848-3216
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Fax | 301-848-3216
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Provider Business Mailing Address
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Address Line | 4205 LAKEVIEW DR P.O. BOX 1433
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City | TEMPLE HILLS
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State | MD
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Zip | 20748-4934
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Country | US
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Telephone | 301-848-3216
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Fax | 301-848-3216
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MS. LINDA JOYCE VAUGHN
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Credential | M.S., CCC-SLP
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Telephone | 301-848-3216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | SLP000247
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | SLP000247
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License Number State | DC
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