Provider Demographics
NPI:1538394218
Name:SUMMIT SPEECH & REHAB, LLC
Entity type:Organization
Organization Name:SUMMIT SPEECH & REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:970-988-7692
Mailing Address - Street 1:4624 FOOTHILLS DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-3456
Mailing Address - Country:US
Mailing Address - Phone:970-988-7692
Mailing Address - Fax:970-635-0079
Practice Address - Street 1:4624 FOOTHILLS DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-3456
Practice Address - Country:US
Practice Address - Phone:970-988-7692
Practice Address - Fax:970-635-0079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-25
Last Update Date:2009-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty