Provider Demographics
NPI:1124541628
Name:BETWEEN THE LINES: A CLINIC OFFERING READING, SPEECH LANGUAGE, AND OCC
Entity Type:Organization
Organization Name:BETWEEN THE LINES: A CLINIC OFFERING READING, SPEECH LANGUAGE, AND OCC
Other - Org Name:BETWEEN THE LINES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:SARA
Authorized Official - Last Name:WAJID
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:609-221-4179
Mailing Address - Street 1:137 EGG HARBOR ROAD
Mailing Address - Street 2:SPACE H
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080
Mailing Address - Country:US
Mailing Address - Phone:609-221-4179
Mailing Address - Fax:
Practice Address - Street 1:137 EGG HARBOR RD STE H
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9404
Practice Address - Country:US
Practice Address - Phone:609-221-4179
Practice Address - Fax:609-221-4179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty