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 |