Provider Demographics
NPI:1952949638
Name:RISE SPEECH AND SWALLOW SOLUTIONS
Entity Type:Organization
Organization Name:RISE SPEECH AND SWALLOW SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-568-1421
Mailing Address - Street 1:6916 STONESTHROW CIR N APT 9102
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-4765
Mailing Address - Country:US
Mailing Address - Phone:248-568-1421
Mailing Address - Fax:
Practice Address - Street 1:6916 STONESTHROW CIR N APT 9102
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-4765
Practice Address - Country:US
Practice Address - Phone:248-568-1421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty