Provider Demographics
NPI:1912359316
Name:INDEPENDENT SPEECH PATHOLOGY NETWORK
Entity Type:Organization
Organization Name:INDEPENDENT SPEECH PATHOLOGY NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH/LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:EURICH
Authorized Official - Suffix:
Authorized Official - Credentials:MS-CCC/SLP
Authorized Official - Phone:808-681-2447
Mailing Address - Street 1:140 KOLEKONA PL
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-9370
Mailing Address - Country:US
Mailing Address - Phone:808-681-2447
Mailing Address - Fax:
Practice Address - Street 1:140 KOLEKONA PL
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-9370
Practice Address - Country:US
Practice Address - Phone:808-681-2447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services