Provider Demographics
NPI:1093570509
Name:NO MUD NO LOTUS LLC
Entity Type:Organization
Organization Name:NO MUD NO LOTUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP, CPA
Authorized Official - Phone:928-224-9370
Mailing Address - Street 1:809 W RIORDAN RD STE 100-258
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-0851
Mailing Address - Country:US
Mailing Address - Phone:928-224-9370
Mailing Address - Fax:
Practice Address - Street 1:809 W RIORDAN RD STE 100-258
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-0851
Practice Address - Country:US
Practice Address - Phone:928-224-9370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty