Provider Demographics
NPI:1326510967
Name:SALISBURY SPEECH THERAPY, LLC
Entity Type:Organization
Organization Name:SALISBURY SPEECH THERAPY, LLC
Other - Org Name:SALISBURY SPEECH THERAPY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PRIMARY SPEECH-LANGUAGE PATH
Authorized Official - Prefix:
Authorized Official - First Name:SOMMER
Authorized Official - Middle Name:L
Authorized Official - Last Name:ASAY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:410-251-8146
Mailing Address - Street 1:1502D PEMBERTON DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-2475
Mailing Address - Country:US
Mailing Address - Phone:410-572-4351
Mailing Address - Fax:443-978-8975
Practice Address - Street 1:1502D PEMBERTON DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-2475
Practice Address - Country:US
Practice Address - Phone:410-572-4351
Practice Address - Fax:443-978-8975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-20
Last Update Date:2021-05-28
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
MD514037401Medicaid