Organization
LIVE WELL SPEECH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE LARSEN (SPEECH LANGUAGE PATHOLOGIST)
(562) 841-2877
Entity
Organization
Contact information
Practice address
1211 S 1530 W, SPRINGVILLE, UT 84663-5074
(562) 841-2877
Mailing address
1211 S 1530 W, SPRINGVILLE, UT 84663-5074
(562) 841-2877
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/12/2023
Last updated
08/28/2023
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