Provider Demographics
NPI:1093250581
Name:PIONEER VALLEY SPEECH AND SWALLOWING SOLUTIONS LLC
Entity Type:Organization
Organization Name:PIONEER VALLEY SPEECH AND SWALLOWING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MA,CCC-SLP
Authorized Official - Phone:413-289-4746
Mailing Address - Street 1:222 MAYNARD RD
Mailing Address - Street 2:
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-1226
Mailing Address - Country:US
Mailing Address - Phone:413-289-4746
Mailing Address - Fax:
Practice Address - Street 1:222 MAYNARD RD
Practice Address - Street 2:
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095-1226
Practice Address - Country:US
Practice Address - Phone:413-289-4746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-20
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty