Provider Demographics
NPI:1619489119
Name:CASA SPEECH, LLC
Entity Type:Organization
Organization Name:CASA SPEECH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:GUARNEROS
Authorized Official - Last Name:ROSILE
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:614-289-8805
Mailing Address - Street 1:523 E ENGLER ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5551
Mailing Address - Country:US
Mailing Address - Phone:614-289-8805
Mailing Address - Fax:614-670-7427
Practice Address - Street 1:523 E ENGLER ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5551
Practice Address - Country:US
Practice Address - Phone:614-299-4554
Practice Address - Fax:614-670-7427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-25
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.12082235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty