Provider Demographics
NPI:1225515257
Name:SPEECH BY THE BEACH INC
Entity Type:Organization
Organization Name:SPEECH BY THE BEACH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-734-1076
Mailing Address - Street 1:2126 HWY 9E
Mailing Address - Street 2:SUITE C4
Mailing Address - City:LONGS
Mailing Address - State:SC
Mailing Address - Zip Code:29568-5753
Mailing Address - Country:US
Mailing Address - Phone:843-734-1076
Mailing Address - Fax:843-734-1107
Practice Address - Street 1:2126 HWY 9E
Practice Address - Street 2:SUITE C4
Practice Address - City:LONGS
Practice Address - State:SC
Practice Address - Zip Code:29568-5753
Practice Address - Country:US
Practice Address - Phone:843-734-1076
Practice Address - Fax:843-734-1107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-23
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8442Medicaid