Provider Demographics
NPI:1407638331
Name:THE SPEECH PEACH, LLC
Entity Type:Organization
Organization Name:THE SPEECH PEACH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/SLP
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CANCHOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:404-431-7351
Mailing Address - Street 1:1217 SILVER MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-8152
Mailing Address - Country:US
Mailing Address - Phone:404-431-7351
Mailing Address - Fax:
Practice Address - Street 1:1217 SILVER MAPLE LN
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-8152
Practice Address - Country:US
Practice Address - Phone:404-431-7351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center