Provider Demographics
NPI:1932976016
Name:SUNSET SPEECH SERVICES
Entity Type:Organization
Organization Name:SUNSET SPEECH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:814-421-4975
Mailing Address - Street 1:1234 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:AMBRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15003-1533
Mailing Address - Country:US
Mailing Address - Phone:814-421-4975
Mailing Address - Fax:
Practice Address - Street 1:1234 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:AMBRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15003-1533
Practice Address - Country:US
Practice Address - Phone:814-421-4975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFESTYLE DEVELOPMENT SOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty