Provider Demographics
NPI:1033962949
Name:SPEECHLYFE PLLC
Entity Type:Organization
Organization Name:SPEECHLYFE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCCAULLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:845-206-3003
Mailing Address - Street 1:9705 BURLESON DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-2304
Mailing Address - Country:US
Mailing Address - Phone:845-206-3003
Mailing Address - Fax:
Practice Address - Street 1:9705 BURLESON DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-2304
Practice Address - Country:US
Practice Address - Phone:845-206-3003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health