Provider Demographics
NPI:1114519964
Name:SPEECHGURU LLC
Entity Type:Organization
Organization Name:SPEECHGURU LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VIOLETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLIKSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-782-3665
Mailing Address - Street 1:32 WHITES AVE APT F5503
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-4305
Mailing Address - Country:US
Mailing Address - Phone:347-782-3665
Mailing Address - Fax:
Practice Address - Street 1:32 WHITES AVE APT F5503
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4305
Practice Address - Country:US
Practice Address - Phone:347-782-3665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty