Provider Demographics
NPI:1538259270
Name:PEDIA-SPEECH, INC.
Entity type:Organization
Organization Name:PEDIA-SPEECH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:CORI
Authorized Official - Last Name:KATLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:561-702-6141
Mailing Address - Street 1:5668 PINECREST CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5331
Mailing Address - Country:US
Mailing Address - Phone:561-702-6141
Mailing Address - Fax:561-361-9179
Practice Address - Street 1:11435 W PALMETTO PARK RD STE J
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-2630
Practice Address - Country:US
Practice Address - Phone:561-702-6141
Practice Address - Fax:561-361-9179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 5357235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty