Provider Demographics
NPI:1437037736
Name:SPEECH SPOT
Entity type:Organization
Organization Name:SPEECH SPOT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLERKIN-MALES
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:804-944-6281
Mailing Address - Street 1:2913 MARINERS PL
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4340
Mailing Address - Country:US
Mailing Address - Phone:804-944-6281
Mailing Address - Fax:
Practice Address - Street 1:2913 MARINERS PL
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4340
Practice Address - Country:US
Practice Address - Phone:804-944-6281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No252Y00000XAgenciesEarly Intervention Provider Agency