Provider Demographics
NPI:1396193819
Name:SPEECH THERAPY SOLUTIONS MONTANA
Entity Type:Organization
Organization Name:SPEECH THERAPY SOLUTIONS MONTANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DAYLINDA
Authorized Official - Middle Name:Q
Authorized Official - Last Name:RADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:406-438-3434
Mailing Address - Street 1:2615 COLONIAL DR LOWR LEVEL
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4910
Mailing Address - Country:US
Mailing Address - Phone:406-422-4213
Mailing Address - Fax:
Practice Address - Street 1:2615 COLONIAL DR LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4910
Practice Address - Country:US
Practice Address - Phone:406-422-4213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1268235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1396193819Medicaid