Provider Demographics
NPI:1023699527
Name:MI SPEECH THERAPY SERVICES
Entity type:Organization
Organization Name:MI SPEECH THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / SLP
Authorized Official - Prefix:MRS
Authorized Official - First Name:HALI
Authorized Official - Middle Name:
Authorized Official - Last Name:LIGHTNER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:810-449-1824
Mailing Address - Street 1:527 S KENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3996
Mailing Address - Country:US
Mailing Address - Phone:810-449-1824
Mailing Address - Fax:
Practice Address - Street 1:527 S KENWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-3996
Practice Address - Country:US
Practice Address - Phone:810-449-1824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech