Organization Name: | HAVEN SPEECH AND SWALLOW SPECIALISTS |
NPI Number: | 1477789212 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BETHANY M RAY (SPEECH PATHOLOGIST/OWNER) |
Mailing Address: | 1709 James River Rd Ozark |
State: | MO US |
Postal Code: | 657216724 |
Phone Number: | 4176936816 |
Fax Number: | 8885503518 |
NPI Enumeration Date: | 06/08/2009 |
NPI Last Update Date: | 02/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2004023139 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
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 |