Provider Demographics
NPI:1417473265
Name:NOVA SPEECH THERAPY L.L.C.
Entity Type:Organization
Organization Name:NOVA SPEECH THERAPY L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSMANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-675-1587
Mailing Address - Street 1:14 KINGS CROFT LN
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2947
Mailing Address - Country:US
Mailing Address - Phone:347-675-1587
Mailing Address - Fax:
Practice Address - Street 1:14 KINGS CROFT LN
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2947
Practice Address - Country:US
Practice Address - Phone:347-675-1587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2022-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty