Provider Demographics
NPI:1043869621
Name:BYRON CENTER SPEECH & LANGUAGE THERAPY LLC
Entity Type:Organization
Organization Name:BYRON CENTER SPEECH & LANGUAGE THERAPY LLC
Other - Org Name:MITTEN SPEECH THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEVON
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWREY
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:616-730-2184
Mailing Address - Street 1:101 WASHINGTON AVE
Mailing Address - Street 2:SUITE B, PMB#177
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49417
Mailing Address - Country:US
Mailing Address - Phone:616-730-2184
Mailing Address - Fax:
Practice Address - Street 1:18019 MOHAWK DR
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:MI
Practice Address - Zip Code:49456-9122
Practice Address - Country:US
Practice Address - Phone:248-622-9198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech