Provider Demographics
NPI:1639981566
Name:BLUEEYES SPEECH AND LANGUAGE SERVICES
Entity type:Organization
Organization Name:BLUEEYES SPEECH AND LANGUAGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:HOLLIS
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:913-530-1737
Mailing Address - Street 1:3546 CALLE SUENOS SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-6716
Mailing Address - Country:US
Mailing Address - Phone:913-530-1737
Mailing Address - Fax:505-396-4598
Practice Address - Street 1:3546 CALLE SUENOS SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-6716
Practice Address - Country:US
Practice Address - Phone:913-530-1737
Practice Address - Fax:505-396-4598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty