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General NPI Number Information
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NPI Number | 1902263031
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Entity Type | Organization
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Legal Business Name | SPEECH'EM
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Dates
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Enumeration Date | 01/20/2016
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Last Update Date | 01/20/2016
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Provider Practice Location Address
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Address Line | 7129 N SARIVAL AVE
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-9796
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Country | US
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Telephone | 623-606-7982
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Fax |
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Provider Business Mailing Address
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Address Line | 7129 N. SARIVAL RD.
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340
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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 | SLP-A
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Name | CAROLYN BOEHMER
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Credential |
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Telephone | 623-606-7982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | AZ
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