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NPI 1811385297

NPI 1811385297 : COMMUNICATE THERAPY SERVICES LLC : MERIDIAN, ID

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General NPI Number Information
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    NPI Number           |    1811385297
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    Entity Type          |    Organization 
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    Legal Business Name  |    COMMUNICATE THERAPY SERVICES LLC 
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Dates
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    Enumeration Date     |    01/07/2015
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    Last Update Date     |    01/07/2015
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Provider Practice Location Address
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    Address Line         |    3882 S CAPULET AVE 
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    City                 |    MERIDIAN
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    State                |    ID
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    Zip                  |    83642-5093
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    Country              |    US
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    Telephone            |    208-863-7854
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3882 S CAPULET AVE 
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    City                 |    MERIDIAN
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    State                |    ID
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    Zip                  |    83642-5093
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     LAURA  WILLOUGHBY 
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    Credential           |    
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    Telephone            |    208-863-7854
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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       |    SLP-1408
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    License Number State |    ID
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