Provider Demographics
NPI:1457964249
Name:SPEAK EASY THERAPEUTICS LLC
Entity Type:Organization
Organization Name:SPEAK EASY THERAPEUTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH AND LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA,CCC-SLP
Authorized Official - Phone:239-246-2400
Mailing Address - Street 1:2090 W FIRST ST APT 2309
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-3123
Mailing Address - Country:US
Mailing Address - Phone:248-224-2791
Mailing Address - Fax:
Practice Address - Street 1:2090 W FIRST ST APT 2309
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-3123
Practice Address - Country:US
Practice Address - Phone:239-246-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty