Provider Demographics
NPI:1508437468
Name:BB SPEECH THERAPY, LLC
Entity Type:Organization
Organization Name:BB SPEECH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BRITT
Authorized Official - Middle Name:BUCHANAN
Authorized Official - Last Name:BURKHALTER
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CCC-SLP
Authorized Official - Phone:601-813-5844
Mailing Address - Street 1:2407 LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-6622
Mailing Address - Country:US
Mailing Address - Phone:601-813-5844
Mailing Address - Fax:
Practice Address - Street 1:2407 LAKE CIR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-6622
Practice Address - Country:US
Practice Address - Phone:601-813-5844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty