Provider Demographics
NPI:1336719590
Name:RICKMAN SPEECH AND LANGUAGE LLC
Entity Type:Organization
Organization Name:RICKMAN SPEECH AND LANGUAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:573-820-2144
Mailing Address - Street 1:10864 COUNTY ROAD 633
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MO
Mailing Address - Zip Code:63841-9129
Mailing Address - Country:US
Mailing Address - Phone:573-820-2144
Mailing Address - Fax:
Practice Address - Street 1:140 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MO
Practice Address - Zip Code:63841-2142
Practice Address - Country:US
Practice Address - Phone:573-820-2144
Practice Address - Fax:888-958-3639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty