Provider Demographics
NPI:1609577055
Name:MAUMEE BAY MOBILE SPEECH SERVICES
Entity type:Organization
Organization Name:MAUMEE BAY MOBILE SPEECH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAYLOR KAE
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:419-504-9198
Mailing Address - Street 1:7010 CORDUROY RD
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-5621
Mailing Address - Country:US
Mailing Address - Phone:419-356-4697
Mailing Address - Fax:
Practice Address - Street 1:445 EARLWOOD AVE STE 108
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-2744
Practice Address - Country:US
Practice Address - Phone:419-504-9198
Practice Address - Fax:888-388-0893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty