Basic Information
| Provider Information | |||||||||
| NPI: | 1285174235 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MAUI CHATTERBOX SPEECH THERAPY L.L.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2747 S KIHEI RD | ||||||||
| Address2: | H205 | ||||||||
| City: | KIHEI | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967539619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083594762 | ||||||||
| FaxNumber: | 8084196501 | ||||||||
| Practice Location | |||||||||
| Address1: | 2747 S KIHEI RD | ||||||||
| Address2: | H205 | ||||||||
| City: | KIHEI | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967539619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083594762 | ||||||||
| FaxNumber: | 8084196501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2017 | ||||||||
| LastUpdateDate: | 02/25/2017 | ||||||||
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| AuthorizedOfficialLastName: | JUNG | ||||||||
| AuthorizedOfficialFirstName: | ASHLEY | ||||||||
| AuthorizedOfficialMiddleName: | FAITH | ||||||||
| AuthorizedOfficialTitleorPosition: | SPEECH LANGUAGE PATHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 8083594762 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SP-1229 | HI | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.