NPI 1053709204 · live from the CMS NPI Registry
Abc Speech Therapy
Speech-Language Pathologist, in Poulsbo, WA. National Provider Identifier 1053709204, active.
NPI record
| NPI | 1053709204 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Speech-Language Pathologist, 235Z00000X |
| Practice location | 19319 7th Ave Ne Ste 104, Poulsbo, WA 98370 |
| Practice phone | 360-830-6757 |
| Enumerated | December 22, 2014 |
| Last updated | December 22, 2014 |
| Authorized official | Robin Rogers, Speech Langauge Pathologist/Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Speech-Language Pathologist, primary | 235Z00000X | 60110522 (WA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.