Theraspeech LLC
Organization Active NPI Speech-Language Pathologist · Springport, IN
NPI 1972010122 · NPPES record last updated Jan 9, 2018
Key facts
- NPI
- 1972010122
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 22004787A (IN)
- Legal business name
- THERASPEECH LLC
- Practice address
- 9314 N Prairie Rd
Springport, IN 47386-9502 - Phone
- (765) 465-8314
- NPI assigned
- Jan 9, 2018
- Organization subpart
- No
Authorized official
- Name
- Angela Dawn Rodriguez, MA CCC-SLP
- Title
- Speech Language Pathologist
- Phone
- (765) 465-8314
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist |
235Z00000X | 22004787A | IN | Yes |
Addresses
Primary practice location
9314 N Prairie Rd
Springport, IN 47386-9502
Mailing address
9314 N Prairie Rd
Springport, IN 47386-9502
Phone (765) 465-8314
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201298110 | Medicaid | IN |
Other providers in Springport, IN
All providers in Springport, IN · Speech-Language Pathologist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.