Provider Demographics
NPI:1316189657
Name:ZEBRA SPEECH
Entity Type:Organization
Organization Name:ZEBRA SPEECH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:URQUHART
Authorized Official - Last Name:GILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:888-828-4114
Mailing Address - Street 1:68 HARVARD STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445
Mailing Address - Country:US
Mailing Address - Phone:888-828-4114
Mailing Address - Fax:888-424-4114
Practice Address - Street 1:68 HARVARD STREET
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445
Practice Address - Country:US
Practice Address - Phone:888-828-4114
Practice Address - Fax:888-424-4114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6493235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty