Provider Demographics
NPI:1720846165
Name:LIFESPAN THERAPY SPECIALISTS LLC
Entity Type:Organization
Organization Name:LIFESPAN THERAPY SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ LEAD SLP
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:PRICE
Authorized Official - Last Name:OLSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:843-410-8122
Mailing Address - Street 1:61 SHELL HALL WAY
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-7861
Mailing Address - Country:US
Mailing Address - Phone:843-410-8122
Mailing Address - Fax:
Practice Address - Street 1:61 SHELL HALL WAY
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-7861
Practice Address - Country:US
Practice Address - Phone:843-410-8122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty