MEDICARE: SPEAK OUT SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician
2	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1003595554
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEAK OUT SERVICES, LLC

Provider Business Mailing Address
First Line	:	826 A ST
Second Line	:
City	:	SPRINGFIELD
State	:	OR
Zip	:	97477-4766
Country	:	US
Telephone Number	:	541-357-5051
Fax Number	:	608-291-7050

Provider Business Practice Location Address
First Line	:	826 A ST
Second Line	:
City	:	SPRINGFIELD
State	:	OR
Zip	:	97477-4766
Country	:	US
Telephone Number	:	402-740-7647
Fax Number	:

Authorized Official
Title or Position	:	CLINIC DIRECTOR
Name	:	CORTNEY BRUMMOND
Credential	:	M.S. CCC-SLP
Telephone Number	:	402-740-7647

Provider Enumeration Date	:	07/12/2023
Last Update Date	:	12/11/2023

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Directions to “SPEAK OUT SERVICES, LLC ” Practice Location

Language	Start Address	Practice Location

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