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NPI Code Detail

MEDICARE: CONNECT SPEECH & LANGUAGE, LLC

MEDICARE: CONNECT SPEECH & LANGUAGE, 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
1235Z00000XSpeech-Language Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235765918
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONNECT SPEECH & LANGUAGE, LLC
Provider Business Mailing Address
First Line : P.O. BOX 110145
Second Line :
City : ANCHORAGE
State : AK
Zip : 99511-0145
Country : US
Telephone Number : 907-887-6181
Fax Number : 844-975-1181
Provider Business Practice Location Address
First Line : 1803 KEPNER DR.
Second Line :
City : ANCHORAGE
State : AK
Zip : 99504-3061
Country : US
Telephone Number : 907-887-6181
Fax Number : 844-975-1181
Authorized Official
Title or Position : OWNER/MANAGING MEMBER
Name : ANDREA SAMUEL
Credential : M.S., CCC-SLP
Telephone Number : 907-887-6181
Provider Enumeration Date : 03/13/2020
Last Update Date : 02/10/2022

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Directions to “CONNECT SPEECH & LANGUAGE, LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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