Provider Demographics
NPI:1003546821
Name:NORTH 42 DEGREES THERAPY PLLC
Entity Type:Organization
Organization Name:NORTH 42 DEGREES THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH AND LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUILE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:734-436-1980
Mailing Address - Street 1:42842 LOMBARDY DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2321
Mailing Address - Country:US
Mailing Address - Phone:734-436-1980
Mailing Address - Fax:734-353-4300
Practice Address - Street 1:42842 LOMBARDY DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2321
Practice Address - Country:US
Practice Address - Phone:734-361-9804
Practice Address - Fax:734-353-4300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty