Provider Demographics
NPI:1679164594
Name:INSPIRED SPEECH, LLC
Entity type:Organization
Organization Name:INSPIRED SPEECH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DENIO
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:805-588-7860
Mailing Address - Street 1:PO BOX 80971
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99708-0971
Mailing Address - Country:US
Mailing Address - Phone:805-588-7860
Mailing Address - Fax:
Practice Address - Street 1:573 WILCOX AVE
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-3626
Practice Address - Country:US
Practice Address - Phone:805-588-7860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty