Provider Demographics
NPI:1033498522
Name:NORTH SHORE CHILDREN'S THERAPIES
Entity Type:Organization
Organization Name:NORTH SHORE CHILDREN'S THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:978-535-3355
Mailing Address - Street 1:1R NEWBURY ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-3864
Mailing Address - Country:US
Mailing Address - Phone:617-529-1573
Mailing Address - Fax:978-535-4655
Practice Address - Street 1:1R NEWBURY ST
Practice Address - Street 2:SUITE 303
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-3864
Practice Address - Country:US
Practice Address - Phone:617-529-1573
Practice Address - Fax:978-535-4655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6457235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty