| Spark Speech Therapy Llc | |
|
206 N Howard St, Fenton, MI 48430-2195 | |
| (810) 429-9545 | |
| Not Available |
| Full Name | Spark Speech Therapy Llc |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 206 N Howard St, Fenton, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801649256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
| Provider Name | Shae Nimmo |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1487423588 PECOS PAC ID: 1658724596 Enrollment ID: I20240127000161 |
| Mailing Address | Practice Location Address |
|---|---|
| Spark Speech Therapy Llc 206 N Howard St, Fenton, MI 48430-2195 Ph: (810) 429-9545 | Spark Speech Therapy Llc 206 N Howard St, Fenton, MI 48430-2195 Ph: (810) 429-9545 |
Rachael Madison Iaquinto, M.A. Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 10498 Carmer Rd, Fenton, MI 48430 Phone: 248-202-9061 | |
Emily Clare Bush, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 545 Edgewood Pass, Fenton, MI 48430 Phone: 248-421-0311 | |
Elyse Lamphier, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 202 W Shiawassee Ave, Fenton, MI 48430 Phone: 810-373-9507 | |
Kari Elizabeth Parnell, M.A. SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 113 N River St, Fenton, MI 48430 Phone: 248-736-9489 | |
Ms. Jennifer Justice, M.A. CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 10449 Carmer Rd, Fenton, MI 48430 Phone: 734-462-1588 | |
Paige Christian Sutton, CF-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 400 Rounds Dr, Fenton, MI 48430 Phone: 810-629-0530 Fax: 810-750-6361 | |
Shae Nimmo, CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 206 N Howard St, Fenton, MI 48430 Phone: 810-429-9545 |