Black Lab Speech Therapy LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

BLACK LAB SPEECH THERAPY LLC

Practice address

1174 E Graystone Way Ste 19
Salt Lake City, UT 84106-2678

Phone

(801) 678-0756

NPI assigned

Aug 6, 2025

Organization subpart

No

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

Authorized official

Name

Jacqueline Valles, MS CCC-SLPNPI 1881223220

Title

Speech Therapist/ Owner

Phone

(801) 678-0756

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Dailey Valles, SLP-CCC

  • Speech-Language Pathologist
  • Salt Lake City, UT
  • NPI 1881223220
  NPD Authorized official

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

{
    "created_epoch": "1754438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754438400000",
    "number": "1730064197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 E GRAYSTONE WAY STE 19",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062678",
            "telephone_number": "801-678-0756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 E GRAYSTONE WAY STE 19",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062678",
            "telephone_number": "801-678-0756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK LAB SPEECH THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-06",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A",
        "authorized_official_last_name": "VALLES",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "SPEECH THERAPIST/ OWNER",
        "authorized_official_telephone_number": "801-678-0756",
        "authorized_official_credential": "MS CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• BKP Dental
• Black Panda LLC (Aeva Specialty Pharmacy)
• Megan E Black-Smith, SLP, M.S, CCC
• Alexa Marie Black, LCSW, PMH-C
• Brian Jerry Black, D.D.S.
• Devin Black

• Speech-Language Pathologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Speech-Language Pathologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.