Provider Demographics
NPI:1750964508
Name:SHOUT IT OUT SPEECH AND LANGUAGE THERAPY
Entity type:Organization
Organization Name:SHOUT IT OUT SPEECH AND LANGUAGE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:VIRGINIA
Authorized Official - Last Name:BARC
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:586-256-0771
Mailing Address - Street 1:22421 VISNAW ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-1334
Mailing Address - Country:US
Mailing Address - Phone:586-330-9080
Mailing Address - Fax:
Practice Address - Street 1:22421 VISNAW ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-1334
Practice Address - Country:US
Practice Address - Phone:586-330-9080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech