Provider Demographics
NPI:1053546267
Name:SPEAK & SWALLOW THERAPY SERVICES
Entity type:Organization
Organization Name:SPEAK & SWALLOW THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAKEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:LADSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:843-543-4746
Mailing Address - Street 1:3870 RHODODENDRON ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154-1691
Mailing Address - Country:US
Mailing Address - Phone:843-543-4746
Mailing Address - Fax:
Practice Address - Street 1:3870 RHODODENDRON ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29154-1691
Practice Address - Country:US
Practice Address - Phone:843-543-4746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3488235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty