Provider Demographics
NPI:1215185533
Name:CONSULTATION-INTERVENTION INC.
Entity Type:Organization
Organization Name:CONSULTATION-INTERVENTION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO, SPEECH LANG. PATH.
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRUBLER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP, TSHH
Authorized Official - Phone:917-355-5060
Mailing Address - Street 1:4206A BELL BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2862
Mailing Address - Country:US
Mailing Address - Phone:917-355-5060
Mailing Address - Fax:718-224-0103
Practice Address - Street 1:21245 26TH AVE
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-1901
Practice Address - Country:US
Practice Address - Phone:917-355-5060
Practice Address - Fax:718-224-0103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010959-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty