# SEASTAR SPEECH THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134414345
- **Authorized official:** MRS. TAMARA ANN GORMAN MS, CCC-SLP (MANAGING MEMBER)
- **Authorized official phone:** (719) 538-6027

## Contact information

- **Practice address:** 1255 LAKE PLAZA DR, SUITE269, COLORADO SPRINGS, CO 80906-3500
- **Practice address phone:** (719) 538-6027
- **Practice address fax:** (719) 344-2328
- **Mailing address:** 1255 LAKE PLAZA DR, SUITE269, COLORADO SPRINGS, CO 80906-3500
- **Mailing address phone:** (719) 538-6027
- **Mailing address fax:** (719) 344-2328

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QH0700X | Hearing and Speech Clinic/Center | 01129463 | CO | Yes |

## Other

- **Enumeration date:** 06/15/2011
- **Last updated:** 06/15/2011