MEDICARE: BEYOND SPEECH 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	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1508535105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEYOND SPEECH LLC

Provider Business Mailing Address
First Line	:	38 S CHELTON RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-2805
Country	:	US
Telephone Number	:	716-697-3210
Fax Number	:

Provider Business Practice Location Address
First Line	:	38 S CHELTON RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-2805
Country	:	US
Telephone Number	:	716-697-3210
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGAGE PATHOLOGIST
Name	:	KELLEY KERR
Credential	:
Telephone Number	:	716-697-3210

Provider Enumeration Date	:	09/08/2021
Last Update Date	:	09/08/2021

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Directions to “BEYOND SPEECH LLC ” Practice Location

Language	Start Address	Practice Location

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