Provider Demographics
NPI:1043543226
Name:SPECTRUM SPEECH AND LANGUAGE SERVICES, LLC
Entity Type:Organization
Organization Name:SPECTRUM SPEECH AND LANGUAGE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:M
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:561-753-4998
Mailing Address - Street 1:12785 W. FOREST HILL BLVD
Mailing Address - Street 2:SUITE 8G
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4777
Mailing Address - Country:US
Mailing Address - Phone:561-753-4998
Mailing Address - Fax:561-753-4911
Practice Address - Street 1:12785 W. FOREST HILL BLVD
Practice Address - Street 2:SUITE 8G
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-4777
Practice Address - Country:US
Practice Address - Phone:561-753-4998
Practice Address - Fax:561-753-4911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-06
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty