Provider Demographics
NPI:1871061226
Name:LOGOS SPEECH THERAPY, INC.
Entity type:Organization
Organization Name:LOGOS SPEECH THERAPY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PERL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:307-337-2400
Mailing Address - Street 1:203 SUNFLOWER ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-3805
Mailing Address - Country:US
Mailing Address - Phone:307-277-6700
Mailing Address - Fax:
Practice Address - Street 1:2510 E 15TH ST STE 15
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4111
Practice Address - Country:US
Practice Address - Phone:307-337-2400
Practice Address - Fax:307-337-2555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-04
Last Update Date:2018-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty