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Organization
PEDS SPEECH LLC
Active
Organization
PEDS SPEECH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAULA ANN GOMOLUCH MACCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(248) 893-6192
Entity
Organization
Contact information
Practice address
30903 W 10 MILE RD STE B, FARMINGTON HILLS, MI 48336
(248) 893-6192
Mailing address
30903 W 10 MILE RD STE B, FARMINGTON HILLS, MI 48336-2615
(248) 893-6192
(248) 457-5490
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101000940
MI
Other
Enumeration date
06/17/2014
Last updated
10/25/2019
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