Provider Demographics
NPI:1902307135
Name:SPEAKING OUT THERAPY SERVICES PLLC
Entity Type:Organization
Organization Name:SPEAKING OUT THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-230-9758
Mailing Address - Street 1:122 COUNTY ROAD 454
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-8239
Mailing Address - Country:US
Mailing Address - Phone:501-230-9758
Mailing Address - Fax:870-520-3655
Practice Address - Street 1:122 COUNTY ROAD 454
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-8239
Practice Address - Country:US
Practice Address - Phone:501-230-9758
Practice Address - Fax:870-520-3655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-22
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty