Provider Demographics
NPI:1023718236
Name:MINDFUL SPEECH AND YOGA, PLLC
Entity type:Organization
Organization Name:MINDFUL SPEECH AND YOGA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:815-651-6089
Mailing Address - Street 1:133 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:IL
Mailing Address - Zip Code:61360-9792
Mailing Address - Country:US
Mailing Address - Phone:815-651-6089
Mailing Address - Fax:
Practice Address - Street 1:133 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:IL
Practice Address - Zip Code:61360-9792
Practice Address - Country:US
Practice Address - Phone:815-651-6089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty