Provider Demographics
NPI:1952958209
Name:WESTON SPEECH DOCTOR
Entity type:Organization
Organization Name:WESTON SPEECH DOCTOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:SLPD
Authorized Official - Phone:954-775-5013
Mailing Address - Street 1:1825 MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3683
Mailing Address - Country:US
Mailing Address - Phone:954-775-5013
Mailing Address - Fax:800-956-2030
Practice Address - Street 1:1825 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3683
Practice Address - Country:US
Practice Address - Phone:954-775-5013
Practice Address - Fax:800-956-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty