Provider Demographics
NPI:1730880113
Name:ADULT SPEECH THERAPY OF MONTANA, LLC
Entity type:Organization
Organization Name:ADULT SPEECH THERAPY OF MONTANA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:A
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:512-826-4111
Mailing Address - Street 1:193 SACAJAWEA PEAK DR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-9366
Mailing Address - Country:US
Mailing Address - Phone:512-826-4111
Mailing Address - Fax:
Practice Address - Street 1:4055 VALLEY COMMONS DR STE F
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6434
Practice Address - Country:US
Practice Address - Phone:512-826-4111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech