Provider Demographics
NPI:1356071146
Name:MYO SPEECH AND FEEDING CENTER
Entity Type:Organization
Organization Name:MYO SPEECH AND FEEDING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SLP
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP, COM
Authorized Official - Phone:781-901-1762
Mailing Address - Street 1:195 HANOVER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-2247
Mailing Address - Country:US
Mailing Address - Phone:178-190-1176
Mailing Address - Fax:
Practice Address - Street 1:195 HANOVER ST STE 1
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2247
Practice Address - Country:US
Practice Address - Phone:178-190-1176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty