Provider Demographics
NPI:1821213901
Name:SPEECH AND LANGUAGE SERVICES, P.C.
Entity Type:Organization
Organization Name:SPEECH AND LANGUAGE SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERLAND
Authorized Official - Middle Name:W
Authorized Official - Last Name:GLEASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-278-3384
Mailing Address - Street 1:156 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-1756
Mailing Address - Country:US
Mailing Address - Phone:517-278-3384
Mailing Address - Fax:517-279-7500
Practice Address - Street 1:156 CHURCH ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-1756
Practice Address - Country:US
Practice Address - Phone:517-278-3384
Practice Address - Fax:517-279-7500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN220022776A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty