Organization Active NPI

Sister Speech PLLC

  • Speech-Language Pathologist
  • West Bloomfield, MI
National Provider Identifier
1609250067
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101002778 Issued in MI
Legal business name
SISTER SPEECH PLLC
Practice address
4681 Wendrick Dr
West Bloomfield, MI 48323-3650
Phone
(248) 214-4646
NPI assigned
Jul 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Maria Dudlar, SPEECH PATHOLOGIST
Title
Owner
Phone
(248) 214-4646

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 7101002778 MI Primary

Addresses

Primary practice location

4681 Wendrick Dr
West Bloomfield, MI 48323-3650

Mailing address

4681 Wendrick Dr
West Bloomfield, MI 48323-3650
Phone (248) 214-4646

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1609250067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4681 WENDRICK DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483233650",
            "telephone_number": "248-214-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4681 WENDRICK DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483233650",
            "telephone_number": "248-214-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISTER SPEECH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "DUDLAR",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-214-4646",
        "authorized_official_credential": "SPEECH PATHOLOGIST"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101002778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.