Provider Demographics
NPI:1164112736
Name:DINO-MITE SPEECH LLC
Entity Type:Organization
Organization Name:DINO-MITE SPEECH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:316-640-2367
Mailing Address - Street 1:609 S LONGBRANCH DR
Mailing Address - Street 2:
Mailing Address - City:MAIZE
Mailing Address - State:KS
Mailing Address - Zip Code:67101-7006
Mailing Address - Country:US
Mailing Address - Phone:316-640-2367
Mailing Address - Fax:
Practice Address - Street 1:609 S LONGBRANCH DR
Practice Address - Street 2:
Practice Address - City:MAIZE
Practice Address - State:KS
Practice Address - Zip Code:67101-7006
Practice Address - Country:US
Practice Address - Phone:316-640-2367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty