Provider Demographics
NPI:1215595996
Name:EDUCATIONAL SPEECH SERVICES PRATTLE ON
Entity Type:Organization
Organization Name:EDUCATIONAL SPEECH SERVICES PRATTLE ON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:D
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:SPEECH THERAPIST
Authorized Official - Phone:301-966-9168
Mailing Address - Street 1:14030 CONNECTICUT AVE UNIT 6410
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20916-7619
Mailing Address - Country:US
Mailing Address - Phone:301-996-9168
Mailing Address - Fax:
Practice Address - Street 1:2804 MOZART DRIVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904
Practice Address - Country:US
Practice Address - Phone:301-996-9168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty