Provider Demographics
NPI:1497483788
Name:MUSTARD SEED SPEECH & LANGUAGE THERAPY LLC
Entity Type:Organization
Organization Name:MUSTARD SEED SPEECH & LANGUAGE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:972-672-9503
Mailing Address - Street 1:48548 SNEAD DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:CO
Mailing Address - Zip Code:80807-9036
Mailing Address - Country:US
Mailing Address - Phone:972-672-9503
Mailing Address - Fax:
Practice Address - Street 1:48548 SNEAD DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:CO
Practice Address - Zip Code:80807-9036
Practice Address - Country:US
Practice Address - Phone:972-672-9503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty