Provider Demographics
NPI:1821558214
Name:SPEECH AND COGNITION SPECIALISTS, LLC
Entity Type:Organization
Organization Name:SPEECH AND COGNITION SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:GWEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:610-909-0111
Mailing Address - Street 1:1100 IMPERIAL DR UNIT 108
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-2453
Mailing Address - Country:US
Mailing Address - Phone:610-909-0111
Mailing Address - Fax:
Practice Address - Street 1:1100 IMPERIAL DR UNIT 108
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-2453
Practice Address - Country:US
Practice Address - Phone:610-909-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech