Provider Demographics
NPI:1295557585
Name:GROWING VOICES SPEECH LANGUAGE PATHOLOGY PLLC
Entity type:Organization
Organization Name:GROWING VOICES SPEECH LANGUAGE PATHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MAIA
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:KOZAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-374-3356
Mailing Address - Street 1:6321 MAYFLOWER LN
Mailing Address - Street 2:
Mailing Address - City:LAKE VIEW
Mailing Address - State:NY
Mailing Address - Zip Code:14085-9683
Mailing Address - Country:US
Mailing Address - Phone:716-374-3356
Mailing Address - Fax:
Practice Address - Street 1:6321 MAYFLOWER LN
Practice Address - Street 2:
Practice Address - City:LAKE VIEW
Practice Address - State:NY
Practice Address - Zip Code:14085-9683
Practice Address - Country:US
Practice Address - Phone:716-374-3356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty