Organization
EAT SPEAK GROW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY E NORDSTROM MS, CCC-SLP (OWNER)
(605) 390-7638
Entity
Organization
Contact information
Practice address
1220 MOUNT RUSHMORE RD STE 1, RAPID CITY, SD 57701-8264
(605) 390-7638
Mailing address
1220 MOUNT RUSHMORE RD STE 1, RAPID CITY, SD 57701-8264
(605) 390-7638
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912308164
—
SD
Enumeration date
09/10/2019
Last updated
09/10/2019
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