Provider Demographics
NPI:1518540244
Name:LOTUS SPEECH & WELLNESS, LLC
Entity Type:Organization
Organization Name:LOTUS SPEECH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOYES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP, CBIS
Authorized Official - Phone:518-265-2930
Mailing Address - Street 1:190 STANFORD ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2138
Mailing Address - Country:US
Mailing Address - Phone:518-265-2930
Mailing Address - Fax:
Practice Address - Street 1:190 STANFORD ST
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2138
Practice Address - Country:US
Practice Address - Phone:518-265-2930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty