Provider Demographics
NPI:1417254426
Name:SPEECH TEACH INC
Entity Type:Organization
Organization Name:SPEECH TEACH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:ROUNTREE
Authorized Official - Suffix:
Authorized Official - Credentials:CCC SLP
Authorized Official - Phone:478-237-6363
Mailing Address - Street 1:420 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-3105
Mailing Address - Country:US
Mailing Address - Phone:478-237-6363
Mailing Address - Fax:478-237-6364
Practice Address - Street 1:420 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SWAINSBORO
Practice Address - State:GA
Practice Address - Zip Code:30401-3105
Practice Address - Country:US
Practice Address - Phone:478-237-6363
Practice Address - Fax:478-237-6364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP000354235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty