Provider Demographics
NPI:1114493129
Name:SPEECH THERAPY ASSOCIATES PLLC
Entity Type:Organization
Organization Name:SPEECH THERAPY ASSOCIATES PLLC
Other - Org Name:ANGEL CARE THERAPEUTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:TREUBIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-485-1266
Mailing Address - Street 1:68 AVENUE A APT 1
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-1802
Mailing Address - Country:US
Mailing Address - Phone:862-485-1266
Mailing Address - Fax:
Practice Address - Street 1:68 AVENUE A APT 1
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-1802
Practice Address - Country:US
Practice Address - Phone:862-485-1266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency