Provider Demographics
NPI:1043541931
Name:SIMPLY SPEAKING INC.
Entity Type:Organization
Organization Name:SIMPLY SPEAKING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KHANEDRA
Authorized Official - Middle Name:EDWARDS
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC, MS-SLP
Authorized Official - Phone:219-331-9514
Mailing Address - Street 1:2909 VILLAGE LN APT 1A
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-2633
Mailing Address - Country:US
Mailing Address - Phone:219-331-9514
Mailing Address - Fax:219-465-6281
Practice Address - Street 1:2909 VILLAGE LN APT 1A
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2633
Practice Address - Country:US
Practice Address - Phone:219-331-9514
Practice Address - Fax:219-465-6281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-17
Last Update Date:2010-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003661A252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency