Provider Demographics
NPI:1144954678
Name:DAKOTA SPEECH AND SWALLOW CENTER
Entity type:Organization
Organization Name:DAKOTA SPEECH AND SWALLOW CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/SPEECH-LANGUAGE PATHOLOGIS
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRASK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-443-6164
Mailing Address - Street 1:4447 S CANYON RD STE 6
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-1889
Mailing Address - Country:US
Mailing Address - Phone:605-443-6164
Mailing Address - Fax:605-412-8021
Practice Address - Street 1:4447 S CANYON RD STE 6
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-1889
Practice Address - Country:US
Practice Address - Phone:605-443-6164
Practice Address - Fax:605-412-8021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-11
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty