Provider Demographics
NPI:1811610066
Name:M.H.A SPEAKOUT SPEAKUP
Entity type:Organization
Organization Name:M.H.A SPEAKOUT SPEAKUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOLIE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-385-5286
Mailing Address - Street 1:418 E PACIFIC AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1456
Mailing Address - Country:US
Mailing Address - Phone:509-385-5286
Mailing Address - Fax:
Practice Address - Street 1:418 E PACIFIC AVE STE 102
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1456
Practice Address - Country:US
Practice Address - Phone:509-385-5286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty