Provider Demographics
NPI:1215534672
Name:KEY 2 SPEECH LLC
Entity Type:Organization
Organization Name:KEY 2 SPEECH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LONDA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:DEROUCHEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:605-347-0660
Mailing Address - Street 1:8226 S BLUCKSBERG MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:SD
Mailing Address - Zip Code:57785-2821
Mailing Address - Country:US
Mailing Address - Phone:605-347-0660
Mailing Address - Fax:
Practice Address - Street 1:8226 S BLUCKSBERG MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:SD
Practice Address - Zip Code:57785-2821
Practice Address - Country:US
Practice Address - Phone:605-347-0660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-07
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1892OtherNORTH DAKOTA STATE BOARD OF EXAMINERS ON AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY
SDS52664OtherMEDICARE
SD581-SLPOtherSOUTH DAKOTA BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY
SD5843992Medicaid
12113942OtherAMERICAN SPEECH HEARING ASSOCIATION
AZSLP12665OtherARIZONA DEPARTMENT OF HEALTH SERVICESS