Provider Demographics
NPI:1568528263
Name:MILESTONES SPEECH AND LAUGUAGE SERVICES
Entity Type:Organization
Organization Name:MILESTONES SPEECH AND LAUGUAGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:509-835-4404
Mailing Address - Street 1:1403 S GRAND BLVD
Mailing Address - Street 2:SUITE 203S
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2263
Mailing Address - Country:US
Mailing Address - Phone:509-835-4404
Mailing Address - Fax:509-835-4400
Practice Address - Street 1:1403 S GRAND BLVD
Practice Address - Street 2:SUITE 203S
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-2263
Practice Address - Country:US
Practice Address - Phone:509-835-4404
Practice Address - Fax:509-835-4400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
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
WA7125701Medicaid