Provider Demographics
NPI:1407147036
Name:SPEECH 4 KIDS CORP.
Entity Type:Organization
Organization Name:SPEECH 4 KIDS CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:ESTELA
Authorized Official - Last Name:RIVAS LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:347-596-5935
Mailing Address - Street 1:4824 210TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-1138
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4824 210TH ST FL 1
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-1138
Practice Address - Country:US
Practice Address - Phone:347-596-5935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-30
Last Update Date:2011-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015519-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty