Provider Demographics
NPI:1932877727
Name:SPEECH HAPPY LLC
Entity Type:Organization
Organization Name:SPEECH HAPPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:HELMINTOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:321-961-7741
Mailing Address - Street 1:3270 SUNTREE BLVD STE 2205
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7558
Mailing Address - Country:US
Mailing Address - Phone:321-961-7741
Mailing Address - Fax:
Practice Address - Street 1:3270 SUNTREE BLVD STE 2205
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7558
Practice Address - Country:US
Practice Address - Phone:321-961-7741
Practice Address - Fax:321-281-9912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-06
Last Update Date:2021-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024903600Medicaid