1376796797 NPI number — SPEECH AND VOICE THERAPY CENTER, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376796797 NPI number — SPEECH AND VOICE THERAPY CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPEECH AND VOICE THERAPY CENTER, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376796797
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 MECHANIC ST
Provider Second Line Business Mailing Address:
SUITE 301
Provider Business Mailing Address City Name:
FOXBORO
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02035-2074
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-698-3709
Provider Business Mailing Address Fax Number:
508-698-3785

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 MECHANIC ST
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
FOXBORO
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02035-2074
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-698-3709
Provider Business Practice Location Address Fax Number:
508-698-3785
Provider Enumeration Date:
10/29/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FRANK
Authorized Official First Name:
SHARON
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
DIRECTOR/OWNER
Authorized Official Telephone Number:
508-698-3709

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)