Provider Demographics
NPI:1679258578
Name:IRONWOOD SPEECH PATHOLOGY LLC
Entity Type:Organization
Organization Name:IRONWOOD SPEECH PATHOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRIOCHOA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:801-678-1277
Mailing Address - Street 1:124 COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-3821
Mailing Address - Country:US
Mailing Address - Phone:801-678-1277
Mailing Address - Fax:
Practice Address - Street 1:124 COLONIAL AVE
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-3821
Practice Address - Country:US
Practice Address - Phone:801-678-1277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-19
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech