Provider Demographics
NPI:1275914491
Name:BUMBLEBEE SPEECH THERAPY, P.C.
Entity Type:Organization
Organization Name:BUMBLEBEE SPEECH THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIROCHNIK
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP/TSLD
Authorized Official - Phone:718-751-5005
Mailing Address - Street 1:48 EXETER ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3704
Mailing Address - Country:US
Mailing Address - Phone:718-751-5005
Mailing Address - Fax:
Practice Address - Street 1:48 EXETER ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3704
Practice Address - Country:US
Practice Address - Phone:718-751-5005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-12
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019776320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities