Provider Demographics
NPI:1003595950
Name:HBK SPEECH LANGUAGE PATHOLOGY LLC
Entity type:Organization
Organization Name:HBK SPEECH LANGUAGE PATHOLOGY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:HUNTER
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANSTROM-KLEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:906-399-6055
Mailing Address - Street 1:4643 US HIGHWAY 2 41
Mailing Address - Street 2:
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-9679
Mailing Address - Country:US
Mailing Address - Phone:906-399-6055
Mailing Address - Fax:
Practice Address - Street 1:2510 1ST AVE N STOP 2
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-1385
Practice Address - Country:US
Practice Address - Phone:906-212-2223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty