Provider Demographics
NPI:1619741816
Name:SPEECH SPARKS LLC
Entity Type:Organization
Organization Name:SPEECH SPARKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:TORRES SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-366-4878
Mailing Address - Street 1:198 HALPINE RD UNIT 2101
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1661
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:198 HALPINE RD UNIT 2101
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1661
Practice Address - Country:US
Practice Address - Phone:301-366-4878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty