Provider Demographics
NPI:1093993941
Name:PROFESSIONAL SPEECH & LANGUAGE SERVICES, PLLC
Entity Type:Organization
Organization Name:PROFESSIONAL SPEECH & LANGUAGE SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCOGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC/SLP
Authorized Official - Phone:936-639-3007
Mailing Address - Street 1:PO BOX 952
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75902-0952
Mailing Address - Country:US
Mailing Address - Phone:936-639-3007
Mailing Address - Fax:936-639-3012
Practice Address - Street 1:4100 S MEDFORD DR STE 208
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-5616
Practice Address - Country:US
Practice Address - Phone:936-639-3007
Practice Address - Fax:936-639-3012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-02
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty