Organization Name: | IOWA SPEECH THERAPY, LLC |
NPI Number: | 1205132123 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JACKIE RAE SUTHERLAND (SPEECH-LANGUAGE PATHOLOGIST/OWNER) |
Mailing Address: | 118 E Main St Suite B Anamosa |
State: | IA US |
Postal Code: | 522051871 |
Phone Number: | 3195332916 |
Fax Number: | 3194620546 |
NPI Enumeration Date: | 02/10/2011 |
NPI Last Update Date: | 04/12/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0700X |
License Number: | 001793 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
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. |