Provider Demographics
NPI:1063816437
Name:SOUND EFFECTS SPEECH THERAPY LLC
Entity Type:Organization
Organization Name:SOUND EFFECTS SPEECH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:ANNE CARRICO
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:502-548-3909
Mailing Address - Street 1:128 PURDY ST
Mailing Address - Street 2:
Mailing Address - City:HIGHTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-3614
Mailing Address - Country:US
Mailing Address - Phone:502-548-3909
Mailing Address - Fax:
Practice Address - Street 1:128 PURDY ST
Practice Address - Street 2:
Practice Address - City:HIGHTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08520-3614
Practice Address - Country:US
Practice Address - Phone:502-548-3909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00757500261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech