Provider Demographics
NPI:1932556065
Name:FIRST WORDS SPEECH AND LANGUAGE CLINIC
Entity Type:Organization
Organization Name:FIRST WORDS SPEECH AND LANGUAGE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:M
Authorized Official - Last Name:WOODWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-SLP
Authorized Official - Phone:406-459-6092
Mailing Address - Street 1:3774 JULIET DRIVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602
Mailing Address - Country:US
Mailing Address - Phone:406-459-6092
Mailing Address - Fax:406-258-0591
Practice Address - Street 1:3774 JULIET DRIVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602
Practice Address - Country:US
Practice Address - Phone:406-459-6092
Practice Address - Fax:406-258-0591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1231235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT7165301Medicaid