Organization · NPI-2

Blue Ridge Speech Therapy, LLC

Speech-Language Pathologist, · Crestview, FL

NPI number1033839386
StatusActive
Last updated in NPPESAug 29, 2022

Details

NPI
1033839386
Entity type
Organization (NPI-2)
Legal business name
Blue Ridge Speech Therapy, LLC
Organization subpart
No
Enumeration date
Aug 29, 2022
Certification date
Aug 29, 2022
Last updated
Aug 29, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,––Yes

Other names

  • Little Lights Speech & Language Services (Doing Business As)

Practice location

329 John King Rd
Crestview, FL 32539-8342

Phone 828-779-2679

Mailing address

329 John King Rd
Crestview, FL 32539-8342

Authorized official

Lindsay Austin
Speech-Language Pathologist
8287792679

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