Provider Demographics
NPI:1629797550
Name:CEDAR LANE SPEECH
Entity Type:Organization
Organization Name:CEDAR LANE SPEECH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:E
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA-CCC/SLP
Authorized Official - Phone:406-813-2181
Mailing Address - Street 1:1928 ST ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-3631
Mailing Address - Country:US
Mailing Address - Phone:763-843-7645
Mailing Address - Fax:
Practice Address - Street 1:1928 ST ANDREWS DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-3631
Practice Address - Country:US
Practice Address - Phone:406-813-2181
Practice Address - Fax:406-630-0872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-24
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty