| Organization Name: | SPEECH CLINIC OF THE COASTAL EMPIRE LLC |
| NPI Number: | 1396120150 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALLSION HERRIN (CO-MANAGER) |
| Mailing Address: | 2591 Us Highway 17 Suite 304d Richmond Hill |
| State: | GA US |
| Postal Code: | 313243864 |
| Phone Number: | 9124592195 |
| Fax Number: | 9124592196 |
| NPI Enumeration Date: | 07/22/2015 |
| NPI Last Update Date: | 11/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| 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 |