Provider Demographics
NPI:1689262909
Name:TALK OF THE TOWN THERAPY, LLC
Entity Type:Organization
Organization Name:TALK OF THE TOWN THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:SWINDOLL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:901-486-8411
Mailing Address - Street 1:1526 SINGLE TREE DR
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632-8048
Mailing Address - Country:US
Mailing Address - Phone:901-486-8411
Mailing Address - Fax:
Practice Address - Street 1:7075 GOLDEN OAKS LOOP W STE 16
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-9013
Practice Address - Country:US
Practice Address - Phone:901-486-8411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-03
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS12327479OtherCAQH