Provider Demographics
NPI:1548420144
Name:SPEECH LANGUAGE AND READING INC
Entity Type:Organization
Organization Name:SPEECH LANGUAGE AND READING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:H
Authorized Official - Last Name:OVERBY
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC SLP
Authorized Official - Phone:423-282-1700
Mailing Address - Street 1:208 SUNSET DRIVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2521
Mailing Address - Country:US
Mailing Address - Phone:423-282-1700
Mailing Address - Fax:423-282-9319
Practice Address - Street 1:208 SUNSET DRIVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2521
Practice Address - Country:US
Practice Address - Phone:423-282-1700
Practice Address - Fax:423-282-9319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4074503OtherBLUE CROSS BLUE SHIELD
4176905OtherBLUE CROSS BLUE SHIELD
4178676OtherBLUE CROSS BLUE SHIELD
TN5442113Medicaid
4176442OtherBLUE CROSS BLUE SHIELD
4178294OtherBLUE CROSS BLUE SHIELD