Provider Demographics
NPI:1922110964
Name:THE TALK SHOPPE, LLC
Entity Type:Organization
Organization Name:THE TALK SHOPPE, LLC
Other - Org Name:THE TALK SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CALLY
Authorized Official - Middle Name:R
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:208-898-0988
Mailing Address - Street 1:1550 N CRESTMONT DR STE E
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-2177
Mailing Address - Country:US
Mailing Address - Phone:208-898-0988
Mailing Address - Fax:
Practice Address - Street 1:1550 N CRESTMONT DR STE E
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-2177
Practice Address - Country:US
Practice Address - Phone:208-898-0988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID15814161OtherMEDICARE PTAN