Provider Demographics
NPI:1801646963
Name:TALK & TASTE PEDIATRIC THERAPY LLC
Entity type:Organization
Organization Name:TALK & TASTE PEDIATRIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KANSAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:STAFFY
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:210-848-9584
Mailing Address - Street 1:6635 S DAYTON ST STE 310 PMB 162
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111
Mailing Address - Country:US
Mailing Address - Phone:210-848-9584
Mailing Address - Fax:
Practice Address - Street 1:101 PALMER ST
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-1731
Practice Address - Country:US
Practice Address - Phone:970-661-2327
Practice Address - Fax:970-718-2251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty