Provider Demographics
NPI:1548664006
Name:SIMPLY SPEECH, PLLC
Entity type:Organization
Organization Name:SIMPLY SPEECH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND SPEECH-LANGUAGE PATHOLOGI
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SKROBARCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:CSCD, CCC-SLP
Authorized Official - Phone:361-792-0822
Mailing Address - Street 1:4455 S PADRE ISLAND DR STE 104
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5125
Mailing Address - Country:US
Mailing Address - Phone:361-792-0822
Mailing Address - Fax:361-288-4109
Practice Address - Street 1:4455 S PADRE ISLAND DR STE 104
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5125
Practice Address - Country:US
Practice Address - Phone:361-792-0822
Practice Address - Fax:361-288-4109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-13
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105580235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty