Provider Demographics
NPI:1164929519
Name:SPEECH WORKS OF ALABAMA, LLC
Entity Type:Organization
Organization Name:SPEECH WORKS OF ALABAMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:IVEY
Authorized Official - Last Name:SENTELL
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:205-385-3448
Mailing Address - Street 1:204 COONER RD
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35503-6708
Mailing Address - Country:US
Mailing Address - Phone:205-385-3448
Mailing Address - Fax:
Practice Address - Street 1:1400 HIGHWAY 78 W STE 200
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-3686
Practice Address - Country:US
Practice Address - Phone:205-385-3448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty