Provider Demographics
NPI:1376000398
Name:HEARTLINE SPEECH THERAPY
Entity Type:Organization
Organization Name:HEARTLINE SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUHL
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:207-831-1049
Mailing Address - Street 1:650 MAIN STREET
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106
Mailing Address - Country:US
Mailing Address - Phone:207-831-1049
Mailing Address - Fax:207-808-8952
Practice Address - Street 1:650 MAIN STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106
Practice Address - Country:US
Practice Address - Phone:207-831-1049
Practice Address - Fax:207-808-8952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty