Provider Demographics
NPI:1689185175
Name:CONVERSATION CONNECTIONS LLC
Entity Type:Organization
Organization Name:CONVERSATION CONNECTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:M
Authorized Official - Last Name:AMIS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:314-502-1333
Mailing Address - Street 1:2000 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-4540
Mailing Address - Country:US
Mailing Address - Phone:314-502-1333
Mailing Address - Fax:
Practice Address - Street 1:2000 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-4540
Practice Address - Country:US
Practice Address - Phone:314-502-1333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014025039235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty