Provider Demographics
NPI:1134654262
Name:KIDS SPEAK THERAPY LLC
Entity Type:Organization
Organization Name:KIDS SPEAK THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BREITOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:347-587-9021
Mailing Address - Street 1:12 MIDTOWN CIR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-7604
Mailing Address - Country:US
Mailing Address - Phone:347-587-9021
Mailing Address - Fax:
Practice Address - Street 1:12 MIDTOWN CIR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-7604
Practice Address - Country:US
Practice Address - Phone:347-587-9021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty