Provider Demographics
NPI:1265878078
Name:FALLS SPEECH AND LANGUAGE SERVICES, LLC
Entity type:Organization
Organization Name:FALLS SPEECH AND LANGUAGE SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:605-254-0090
Mailing Address - Street 1:4095 E RUSTLER WAY
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-8382
Mailing Address - Country:US
Mailing Address - Phone:605-254-0090
Mailing Address - Fax:
Practice Address - Street 1:3210 S GILBERT RD
Practice Address - Street 2:SUITE 1-E
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-5108
Practice Address - Country:US
Practice Address - Phone:605-254-0090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty