Organization
SPEECH SPARK SERVICES, LLC
Active
Other names
Speech Spark
Organization subpart
No
Provider details
NPI number
Authorized official
BETH DOLAR M.S. CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(920) 403-0103
Entity
Organization
Contact information
Practice address
1924 SINCLAIR DR, DE PERE, WI 54115-7530
(920) 403-0103
(888) 631-0117
Mailing address
1924 SINCLAIR DR, DE PERE, WI 54115-7530
(920) 403-0103
(888) 631-0117
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2614-154
WI
Other
Enumeration date
09/06/2016
Last updated
12/07/2016
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