Provider Demographics
NPI:1114539053
Name:PEAS AND CARROTS SPEECH AND FEEDING THERAPY, LLC
Entity Type:Organization
Organization Name:PEAS AND CARROTS SPEECH AND FEEDING THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACLYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENOIT
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:774-406-0799
Mailing Address - Street 1:6 MONUMENT HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1014
Mailing Address - Country:US
Mailing Address - Phone:774-406-0799
Mailing Address - Fax:
Practice Address - Street 1:6 MONUMENT HILL RD
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1014
Practice Address - Country:US
Practice Address - Phone:774-406-0799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEAS AND CARROTS SPEECH AND FEEDING THERAPY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty