| Organization Name: | CONNECTED COMMUNICATION THERAPY SERVICES LLC |
| NPI Number: | 1093192593 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENDRA ROUTH (SPEECH-LANGUAGE PATHOLOGIST) |
| Mailing Address: | 207 34th Ave E West Fargo |
| State: | ND US |
| Postal Code: | 580787975 |
| Phone Number: | 2183295888 |
| Fax Number: | |
| NPI Enumeration Date: | 05/04/2015 |
| NPI Last Update Date: | 05/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0700X |
| License Number: | 942 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Hearing and Speech |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, prescriptive, and therapy services related to congenital and acquired conditions and diseases that affect hearing capacity and speech ability. |