Provider Demographics
NPI:1740003482
Name:CONCIERGE SPEECH BIRMINGHAM LLC
Entity type:Organization
Organization Name:CONCIERGE SPEECH BIRMINGHAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CANARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-401-1503
Mailing Address - Street 1:5461 11TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35222-4041
Mailing Address - Country:US
Mailing Address - Phone:251-401-1503
Mailing Address - Fax:
Practice Address - Street 1:5461 11TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35222-4041
Practice Address - Country:US
Practice Address - Phone:251-401-1503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center