| Organization Name: | DYNAMIC SPEECH THERAPY, LLC |
| NPI Number: | 1356646665 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEENAN PAIGE GLAZAR (OWNER/SPEECH LANGUAGE PATHOLOGIST) |
| Mailing Address: | 21751 Ladbroke Grove Ct Sterling |
| State: | VA US |
| Postal Code: | 201669290 |
| Phone Number: | 5712440316 |
| Fax Number: | 7034211212 |
| NPI Enumeration Date: | 01/18/2011 |
| NPI Last Update Date: | 01/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2202004993 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |