Provider Demographics
NPI:1922459825
Name:HEART TO HEART SPEECH SERVICES, PLLC
Entity Type:Organization
Organization Name:HEART TO HEART SPEECH SERVICES, PLLC
Other - Org Name:HEART TO HEART SPEECH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH/LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAYCIE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:580-786-5075
Mailing Address - Street 1:1313 W ASH AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-4358
Mailing Address - Country:US
Mailing Address - Phone:580-786-5075
Mailing Address - Fax:
Practice Address - Street 1:1313 W ASH AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-4358
Practice Address - Country:US
Practice Address - Phone:580-786-5075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK562355S0801X
OK4456235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty