Provider Demographics
NPI:1013358829
Name:OHIO VALLEY SPEECH & LANGUAGE CENTER LLC
Entity Type:Organization
Organization Name:OHIO VALLEY SPEECH & LANGUAGE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCALES
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:812-490-7760
Mailing Address - Street 1:1713 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47601-2135
Mailing Address - Country:US
Mailing Address - Phone:812-490-7760
Mailing Address - Fax:
Practice Address - Street 1:605 STATE ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-1299
Practice Address - Country:US
Practice Address - Phone:812-490-7760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22005103A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty