Provider Demographics
NPI:1518502095
Name:HEARTSONG SPEECH AND FEEDING, LLC
Entity Type:Organization
Organization Name:HEARTSONG SPEECH AND FEEDING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:574-703-1713
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IN
Mailing Address - Zip Code:46554-0316
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:509 W MCKINLEY AVE STE 3
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-5564
Practice Address - Country:US
Practice Address - Phone:574-703-1713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech