Provider Demographics
NPI:1235475179
Name:LOGOS SPEECH LLC
Entity Type:Organization
Organization Name:LOGOS SPEECH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANASTASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGIOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-451-8867
Mailing Address - Street 1:110 RIVER DR APT 210
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-2059
Mailing Address - Country:US
Mailing Address - Phone:201-451-8867
Mailing Address - Fax:
Practice Address - Street 1:129 NEWARK AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-2811
Practice Address - Country:US
Practice Address - Phone:201-451-8867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00547800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty