Provider Demographics
NPI:1003698275
Name:THE SPEECH GARDEN OF ANKENY
Entity Type:Organization
Organization Name:THE SPEECH GARDEN OF ANKENY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGHIEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS/CCC-SLP
Authorized Official - Phone:515-204-4507
Mailing Address - Street 1:3905 NE BELLAGIO CIR
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-6864
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:515-608-4486
Practice Address - Street 1:3905 NE BELLAGIO CIR
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-6864
Practice Address - Country:US
Practice Address - Phone:515-204-4507
Practice Address - Fax:515-608-4486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty