Provider Demographics
NPI:1750065660
Name:SPEAK UP THERAPY SOLUTIONS, PLLC
Entity type:Organization
Organization Name:SPEAK UP THERAPY SOLUTIONS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP/L
Authorized Official - Phone:815-990-0801
Mailing Address - Street 1:1245 LACRESTA DR
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:61032-6161
Mailing Address - Country:US
Mailing Address - Phone:815-990-0801
Mailing Address - Fax:
Practice Address - Street 1:524 W STEPHENSON ST STE 211
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:IL
Practice Address - Zip Code:61032-5058
Practice Address - Country:US
Practice Address - Phone:815-990-0801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech