Provider Demographics
NPI:1407382369
Name:BEYOND WORDS THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:BEYOND WORDS THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:TIBBETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-419-6167
Mailing Address - Street 1:123 SAINT ABIGAIL LN
Mailing Address - Street 2:
Mailing Address - City:WOODWORTH
Mailing Address - State:LA
Mailing Address - Zip Code:71485-4703
Mailing Address - Country:US
Mailing Address - Phone:318-419-6167
Mailing Address - Fax:
Practice Address - Street 1:123 SAINT ABIGAIL LN
Practice Address - Street 2:
Practice Address - City:WOODWORTH
Practice Address - State:LA
Practice Address - Zip Code:71485-4703
Practice Address - Country:US
Practice Address - Phone:318-419-6167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4866235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty