Provider Demographics
NPI:1003436700
Name:SPEAKN UP LLC
Entity Type:Organization
Organization Name:SPEAKN UP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BISTLINE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:928-606-3565
Mailing Address - Street 1:PO BOX 843
Mailing Address - Street 2:
Mailing Address - City:FREDONIA
Mailing Address - State:AZ
Mailing Address - Zip Code:86022-0843
Mailing Address - Country:US
Mailing Address - Phone:928-606-3565
Mailing Address - Fax:928-643-6554
Practice Address - Street 1:45 N FIRST EAST ST
Practice Address - Street 2:
Practice Address - City:FREDONIA
Practice Address - State:AZ
Practice Address - Zip Code:86022-0079
Practice Address - Country:US
Practice Address - Phone:928-606-3565
Practice Address - Fax:928-643-6554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty