Provider Demographics
NPI:1457116634
Name:SPEECH 4 KIDS
Entity Type:Organization
Organization Name:SPEECH 4 KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:POTTEIGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-622-7080
Mailing Address - Street 1:15643 HENNINGFORD RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-2134
Mailing Address - Country:US
Mailing Address - Phone:703-732-7313
Mailing Address - Fax:703-940-8377
Practice Address - Street 1:12802 NATHAN CT
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-2956
Practice Address - Country:US
Practice Address - Phone:703-732-7313
Practice Address - Fax:703-940-8377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty