Provider Demographics
NPI:1871230649
Name:THE SPEECH LAB LLC
Entity Type:Organization
Organization Name:THE SPEECH LAB LLC
Other - Org Name:THE SPEECH LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LOREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTRELL FINCK
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:573-473-2394
Mailing Address - Street 1:2434 SOUTHERN HLS
Mailing Address - Street 2:
Mailing Address - City:MEXICO
Mailing Address - State:MO
Mailing Address - Zip Code:65265-1663
Mailing Address - Country:US
Mailing Address - Phone:573-473-2394
Mailing Address - Fax:
Practice Address - Street 1:222 S JEFFERSON ST STE 201
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:MO
Practice Address - Zip Code:65265-2876
Practice Address - Country:US
Practice Address - Phone:573-473-2394
Practice Address - Fax:573-519-5307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty