Provider Demographics
NPI:1275110876
Name:LIL TALKERS SPEECH LLC
Entity Type:Organization
Organization Name:LIL TALKERS SPEECH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROXANA
Authorized Official - Middle Name:D
Authorized Official - Last Name:LIEBERG JORDHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:701-330-7772
Mailing Address - Street 1:638 NE DAKOTA CT
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-1117
Mailing Address - Country:US
Mailing Address - Phone:701-330-7772
Mailing Address - Fax:
Practice Address - Street 1:115 W HERMISTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-1761
Practice Address - Country:US
Practice Address - Phone:701-330-7772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-28
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty