Provider Demographics
NPI:1407944598
Name:PEDIATRIC SPEECH & LANGUAGE SERVICES,LLC
Entity Type:Organization
Organization Name:PEDIATRIC SPEECH & LANGUAGE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:PEARL
Authorized Official - Last Name:ALBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:317-873-3848
Mailing Address - Street 1:12918 REEDY CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8753
Mailing Address - Country:US
Mailing Address - Phone:317-873-3848
Mailing Address - Fax:
Practice Address - Street 1:12918 REEDY CT
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-8753
Practice Address - Country:US
Practice Address - Phone:317-873-3848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty