Organization
SPEECH SPARK THERAPY SERVICES LLC
Active
Other names
Speech Spark SLP
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH J LIAN CCC-SLP (OWNER/PRESIDENT)
(314) 690-8521
Entity
Organization
Contact information
Practice address
8764 ROSALIE AVE UNIT 440162, SAINT LOUIS, MO 63144-5026
(314) 690-8521
Mailing address
1241 STRASSNER DR APT 1402, BRENTWOOD, MO 63144-1876
(904) 303-0183
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2017016066
MO
Other
Enumeration date
07/08/2018
Last updated
07/31/2018
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