Provider Demographics
NPI:1316686025
Name:RADIANT SPEECH & LANGUAGE, LLC
Entity type:Organization
Organization Name:RADIANT SPEECH & LANGUAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-962-0146
Mailing Address - Street 1:11711 ARBOR ST STE 240
Mailing Address - Street 2:SUITE I
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2952
Mailing Address - Country:US
Mailing Address - Phone:308-962-0146
Mailing Address - Fax:
Practice Address - Street 1:11711 ARBOR ST STE 240
Practice Address - Street 2:SUITE I
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2952
Practice Address - Country:US
Practice Address - Phone:308-962-0146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty