Provider Demographics
NPI:1356735245
Name:I TEACH SPEECH, LLC
Entity type:Organization
Organization Name:I TEACH SPEECH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:SYPOLT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC/SLP
Authorized Official - Phone:407-325-1199
Mailing Address - Street 1:4820 INNISBROOK CT S
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:FL
Mailing Address - Zip Code:32033-2067
Mailing Address - Country:US
Mailing Address - Phone:407-325-1199
Mailing Address - Fax:904-404-7453
Practice Address - Street 1:4820 INNISBROOK CT S
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:FL
Practice Address - Zip Code:32033-2067
Practice Address - Country:US
Practice Address - Phone:407-325-1199
Practice Address - Fax:904-404-7453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8548235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty