Provider Demographics
NPI:1356011076
Name:SPEECH ON THE GO
Entity Type:Organization
Organization Name:SPEECH ON THE GO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MALINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:KEMP
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:704-267-6172
Mailing Address - Street 1:365 BONAVENTURE DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28147-6813
Mailing Address - Country:US
Mailing Address - Phone:704-267-6172
Mailing Address - Fax:704-603-8834
Practice Address - Street 1:365 BONAVENTURE DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-6813
Practice Address - Country:US
Practice Address - Phone:704-267-6172
Practice Address - Fax:704-603-8834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty