=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912617085
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A TO Z SPEECH THERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/30/2022
-----------------------------------------------------
Last Update Date | 11/30/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 425 S 7TH ST
-----------------------------------------------------
City | BRIGHTON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48116-1419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-660-4665
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 425 S 7TH ST
-----------------------------------------------------
City | BRIGHTON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48116-1419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH-LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | RACHEL AMMON
-----------------------------------------------------
Credential | M.A., CCC-SLP
-----------------------------------------------------
Telephone | 734-660-4661
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------