Provider Demographics
NPI:1275946808
Name:BEYOND SPEECH THERAPY SPECIALISTS LLC
Entity Type:Organization
Organization Name:BEYOND SPEECH THERAPY SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP/L
Authorized Official - Phone:779-435-0724
Mailing Address - Street 1:PO BOX 405
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-0405
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1621 ANDREA DR
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-2303
Practice Address - Country:US
Practice Address - Phone:779-435-0724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty