Provider Demographics
NPI:1629507843
Name:SPEECH THERAPY AND EDUCATION PROFESSIONALS, LLC
Entity Type:Organization
Organization Name:SPEECH THERAPY AND EDUCATION PROFESSIONALS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:941-251-6825
Mailing Address - Street 1:872 62ND STREET CIR E STE 101-103
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-6238
Mailing Address - Country:US
Mailing Address - Phone:941-251-6825
Mailing Address - Fax:941-201-1626
Practice Address - Street 1:872 62ND STREET CIR E STE 101-103
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-6238
Practice Address - Country:US
Practice Address - Phone:941-251-6825
Practice Address - Fax:941-201-1626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-09
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty