Provider Demographics
NPI:1093364689
Name:BAILEY COVE SPEECH THERAPY
Entity Type:Organization
Organization Name:BAILEY COVE SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFREYS
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:256-535-7765
Mailing Address - Street 1:PO BOX 12212
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35815-2212
Mailing Address - Country:US
Mailing Address - Phone:256-535-7765
Mailing Address - Fax:256-715-5045
Practice Address - Street 1:1429 WEATHERLY RD SE STE A
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35803-1187
Practice Address - Country:US
Practice Address - Phone:256-535-7765
Practice Address - Fax:256-715-5045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty