Provider Demographics
NPI:1205693488
Name:SPEECH EAT LEARN LLC
Entity type:Organization
Organization Name:SPEECH EAT LEARN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:STEPHANIE
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:305-989-9187
Mailing Address - Street 1:9858 CLINT MOORE RD STE C111-207
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-1034
Mailing Address - Country:US
Mailing Address - Phone:561-203-5383
Mailing Address - Fax:
Practice Address - Street 1:5502 BROKEN SOUND BLVD NW APT 3103
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-3547
Practice Address - Country:US
Practice Address - Phone:305-989-9187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech