Provider Demographics
NPI:1164049730
Name:YARDLEY SPEECH THERAPY INC
Entity Type:Organization
Organization Name:YARDLEY SPEECH THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HALLGREN
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:734-765-2262
Mailing Address - Street 1:1432 HUNTERS LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48380-3246
Mailing Address - Country:US
Mailing Address - Phone:734-765-2262
Mailing Address - Fax:
Practice Address - Street 1:1432 HUNTERS LAKE DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48380-3246
Practice Address - Country:US
Practice Address - Phone:734-765-2262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
1609343607OtherNPI