Provider Demographics
NPI:1275137242
Name:NOT JUST SPEECH LLC
Entity Type:Organization
Organization Name:NOT JUST SPEECH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTODOULOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-903-4117
Mailing Address - Street 1:793 TROY CT
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-1026
Mailing Address - Country:US
Mailing Address - Phone:732-903-4117
Mailing Address - Fax:
Practice Address - Street 1:793 TROY CT
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-1026
Practice Address - Country:US
Practice Address - Phone:732-903-4117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ41YS00629400OtherHORIZON BLUE CROSS BLUE SHIELD OF NJ