Provider Demographics
NPI:1851949044
Name:SIMPLY SPEECH & LANGUAGE SERVICES
Entity Type:Organization
Organization Name:SIMPLY SPEECH & LANGUAGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:989-878-0630
Mailing Address - Street 1:PO BOX 3272
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48605-3272
Mailing Address - Country:US
Mailing Address - Phone:989-797-1400
Mailing Address - Fax:989-797-4077
Practice Address - Street 1:9453 KOCHVILLE RD
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:MI
Practice Address - Zip Code:48623-8623
Practice Address - Country:US
Practice Address - Phone:989-878-0630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty