Provider Demographics
NPI:1043098569
Name:SUCCESSFUL EXPRESSION, LLC
Entity Type:Organization
Organization Name:SUCCESSFUL EXPRESSION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SLP
Authorized Official - Prefix:MISS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:ABRAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:617-213-0292
Mailing Address - Street 1:65 BEACON ST APT 201
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-4379
Mailing Address - Country:US
Mailing Address - Phone:617-213-0292
Mailing Address - Fax:
Practice Address - Street 1:65 BEACON ST APT 201
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-4379
Practice Address - Country:US
Practice Address - Phone:617-213-0292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech