Provider Demographics
NPI:1881351773
Name:NORTHERN VERMONT SPEECH THERAPY, PLC
Entity type:Organization
Organization Name:NORTHERN VERMONT SPEECH THERAPY, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:GRIMS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:802-242-5800
Mailing Address - Street 1:PO BOX 1220
Mailing Address - Street 2:
Mailing Address - City:ENOSBURG FALLS
Mailing Address - State:VT
Mailing Address - Zip Code:05450-1220
Mailing Address - Country:US
Mailing Address - Phone:802-242-5800
Mailing Address - Fax:
Practice Address - Street 1:670 KING RD
Practice Address - Street 2:
Practice Address - City:RICHFORD
Practice Address - State:VT
Practice Address - Zip Code:05476-9509
Practice Address - Country:US
Practice Address - Phone:802-242-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-26
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech