Provider Demographics
NPI:1437715513
Name:SPEECH LANGUAGE SERVICES
Entity Type:Organization
Organization Name:SPEECH LANGUAGE SERVICES
Other - Org Name:SPEECH LANGUAGE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KELCI
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:808-294-4888
Mailing Address - Street 1:PO BOX 283197
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96828-3197
Mailing Address - Country:US
Mailing Address - Phone:808-294-4888
Mailing Address - Fax:
Practice Address - Street 1:460 ENA RD STE 505
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1774
Practice Address - Country:US
Practice Address - Phone:808-294-4888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-14
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty