Organization
PROGRESSIVE SPEECH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARA LYNN MYRVOLD M.S. CCC-SLP (PRESIDENT/ SPEECH PATHOLOGIST)
(317) 598-1483
Entity
Organization
Contact information
Practice address
12668 LARGO DR, FISHERS, IN 46037-8188
(317) 598-1483
(317) 598-1483
Mailing address
12668 LARGO DR, FISHERS, IN 46037-8188
(317) 598-1483
(317) 598-1483
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22002720A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200716160 A
LPI (LEGACY PROVIDER IDENTIFIER
IN
Enumeration date
10/03/2008
Last updated
10/03/2008
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