Provider Demographics
NPI:1407573959
Name:SPEECH WARRIOR SPEECH THERAPY, LLC
Entity Type:Organization
Organization Name:SPEECH WARRIOR SPEECH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:TIERNEY
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:201-300-7360
Mailing Address - Street 1:99 KINDERKAMACK RD STE 303
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3012
Mailing Address - Country:US
Mailing Address - Phone:201-300-7360
Mailing Address - Fax:201-497-3255
Practice Address - Street 1:99 KINDERKAMACK RD STE 303
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3012
Practice Address - Country:US
Practice Address - Phone:201-300-7360
Practice Address - Fax:201-497-3255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty