Provider Demographics
NPI:1003059767
Name:ALL ABOUT SPEECH, CORP
Entity Type:Organization
Organization Name:ALL ABOUT SPEECH, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JUNETTE
Authorized Official - Middle Name:HOPE
Authorized Official - Last Name:MCGOUGIN
Authorized Official - Suffix:
Authorized Official - Credentials:MCD, CCC-SLP
Authorized Official - Phone:504-606-6140
Mailing Address - Street 1:3110 JUDSON ST
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1254
Mailing Address - Country:US
Mailing Address - Phone:504-606-6140
Mailing Address - Fax:188-857-1785
Practice Address - Street 1:3206 50TH STREET CT NW
Practice Address - Street 2:SUITE 101 BUILDING A
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8556
Practice Address - Country:US
Practice Address - Phone:504-606-6140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-10
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004290261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALL00004290OtherWASHINGTON STATE LICENSE