Provider Demographics
NPI:1780210385
Name:SPEECH, LANGUAGE, AND CONSULTATIVE SERIVES, LLC
Entity Type:Organization
Organization Name:SPEECH, LANGUAGE, AND CONSULTATIVE SERIVES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-699-7232
Mailing Address - Street 1:450 BIRCH AVE SW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32908-7515
Mailing Address - Country:US
Mailing Address - Phone:954-669-7232
Mailing Address - Fax:
Practice Address - Street 1:450 BIRCH AVE SW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32908-7515
Practice Address - Country:US
Practice Address - Phone:954-669-7232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty