Provider Demographics
NPI:1114640232
Name:JUBILEE SPEECH THERAPY LLC
Entity Type:Organization
Organization Name:JUBILEE SPEECH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LANIER
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:985-707-5599
Mailing Address - Street 1:12482 CRESSIDA LOOP
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-9294
Mailing Address - Country:US
Mailing Address - Phone:985-707-5599
Mailing Address - Fax:
Practice Address - Street 1:12482 CRESSIDA LOOP
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-9294
Practice Address - Country:US
Practice Address - Phone:985-707-5599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-23
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty