Organization Name: | SPEECH 4 KIDS, P.C. |
NPI Number: | 1447249651 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KYNDA POTTORFF (PRESIDENT) |
Mailing Address: | Rr 3 Box 947 County Rd. 950 North Fairfield |
State: | IL US |
Postal Code: | 628379036 |
Phone Number: | 6188475437 |
Fax Number: | 6188475438 |
NPI Enumeration Date: | 10/19/2005 |
NPI Last Update Date: | 07/08/2007 |
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 |