Provider Demographics
NPI: | 1760214936 |
---|---|
Name: | COLE SPEECH & LANGUAGE LLC |
Entity type: | Organization |
Organization Name: | COLE SPEECH & LANGUAGE LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | SPEECH-LANGUAGE PATHOLOGIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MIRIAM |
Authorized Official - Middle Name: | H |
Authorized Official - Last Name: | COLE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MS CCC, SLP |
Authorized Official - Phone: | 540-226-0129 |
Mailing Address - Street 1: | 23 TWIN LAKE CT |
Mailing Address - Street 2: | |
Mailing Address - City: | FREDERICKSBURG |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 22405-2892 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 540-226-0130 |
Mailing Address - Fax: | 540-372-3735 |
Practice Address - Street 1: | 23 TWIN LAKE CT |
Practice Address - Street 2: | |
Practice Address - City: | FREDERICKSBURG |
Practice Address - State: | VA |
Practice Address - Zip Code: | 22405-2892 |
Practice Address - Country: | US |
Practice Address - Phone: | 540-226-0130 |
Practice Address - Fax: | 540-372-3735 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-08-16 |
Last Update Date: | 2024-08-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Single Specialty |