Provider Demographics
NPI:1073258257
Name:CELESTIAL SPEECH THERAPY
Entity Type:Organization
Organization Name:CELESTIAL SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KAPENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:AURIZIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-355-8834
Mailing Address - Street 1:727 E LANDIS AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-8001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:727 E LANDIS AVE STE 3
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-8001
Practice Address - Country:US
Practice Address - Phone:856-355-8834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty