Provider Demographics
NPI:1366258063
Name:SUNSHINE SPEECH, LLC
Entity type:Organization
Organization Name:SUNSHINE SPEECH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS-KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC
Authorized Official - Phone:904-386-1012
Mailing Address - Street 1:3622 NE CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-2011
Mailing Address - Country:US
Mailing Address - Phone:904-386-1012
Mailing Address - Fax:
Practice Address - Street 1:3622 NE CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-2011
Practice Address - Country:US
Practice Address - Phone:904-386-1012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty