Organization
BLACK LAB SPEECH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE VALLES MS CCC-SLP (SPEECH THERAPIST/ OWNER)
(801) 678-0756
Entity
Organization
Contact information
Practice address
1174 E GRAYSTONE WAY STE 19, SALT LAKE CITY, UT 84106-2678
(801) 678-0756
Mailing address
1174 E GRAYSTONE WAY STE 19, SALT LAKE CITY, UT 84106-2678
(801) 678-0756
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/06/2025
Last updated
08/06/2025
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