Provider Demographics
NPI:1912491432
Name:MY TURN PEDIATRIC SPEECH THERAPY, LLC
Entity Type:Organization
Organization Name:MY TURN PEDIATRIC SPEECH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLMORE
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:503-830-6315
Mailing Address - Street 1:8660 SPRING MOUNTAIN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-4101
Mailing Address - Country:US
Mailing Address - Phone:702-462-5252
Mailing Address - Fax:702-685-5009
Practice Address - Street 1:8660 SPRING MOUNTAIN RD STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-4101
Practice Address - Country:US
Practice Address - Phone:702-462-5252
Practice Address - Fax:702-685-5009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-18
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech