Provider Demographics
NPI:1861741928
Name:CHATTERBOKS SPEECH THERAPY PC
Entity type:Organization
Organization Name:CHATTERBOKS SPEECH THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SPEECH LANGUAGE PATHOLOGY
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:541-913-4740
Mailing Address - Street 1:2783 RIDGEWAY DR SE
Mailing Address - Street 2:
Mailing Address - City:TURNER
Mailing Address - State:OR
Mailing Address - Zip Code:97392-9370
Mailing Address - Country:US
Mailing Address - Phone:541-913-4740
Mailing Address - Fax:503-581-8906
Practice Address - Street 1:2783 RIDGEWAY DR SE
Practice Address - Street 2:
Practice Address - City:TURNER
Practice Address - State:OR
Practice Address - Zip Code:97392-9370
Practice Address - Country:US
Practice Address - Phone:541-913-4740
Practice Address - Fax:503-581-8906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12695235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty