Provider Demographics
NPI:1083120877
Name:SMALL TALK LLC
Entity Type:Organization
Organization Name:SMALL TALK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDDINS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:860-385-4327
Mailing Address - Street 1:145 NEW LONDON TPKE UNIT 1105
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-7042
Mailing Address - Country:US
Mailing Address - Phone:860-385-4327
Mailing Address - Fax:844-675-3499
Practice Address - Street 1:109 WESTLAND AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-3057
Practice Address - Country:US
Practice Address - Phone:860-385-4327
Practice Address - Fax:844-675-3499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-16
Last Update Date:2017-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004510235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty