Provider Demographics
NPI:1255514543
Name:CHATTERBOX SPEECH, LLC
Entity type:Organization
Organization Name:CHATTERBOX SPEECH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC/SLP-L
Authorized Official - Phone:618-520-2498
Mailing Address - Street 1:3418 MANASSAS DR
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-3209
Mailing Address - Country:US
Mailing Address - Phone:618-520-2498
Mailing Address - Fax:618-692-9633
Practice Address - Street 1:3418 MANASSAS DR
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-3209
Practice Address - Country:US
Practice Address - Phone:618-520-2498
Practice Address - Fax:618-692-9633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty