Provider Demographics
NPI:1700254653
Name:SPEAK FOR YOURSELF, LLC
Entity Type:Organization
Organization Name:SPEAK FOR YOURSELF, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN MATT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:281-684-1818
Mailing Address - Street 1:2180 NORTH LOOP W STE 160
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-8001
Mailing Address - Country:US
Mailing Address - Phone:832-831-0043
Mailing Address - Fax:832-200-2266
Practice Address - Street 1:2180 NORTH LOOP W STE 160
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-8001
Practice Address - Country:US
Practice Address - Phone:328-310-0438
Practice Address - Fax:832-200-2266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-09
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107087235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX435313OtherMEDICARE PTAN