Provider Demographics
NPI:1467780619
Name:AFFILIATES OF SPEECH THERAPY, P.C.
Entity Type:Organization
Organization Name:AFFILIATES OF SPEECH THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ABID
Authorized Official - Middle Name:A
Authorized Official - Last Name:BASHIR
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:734-829-7188
Mailing Address - Street 1:5900 COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-8203
Mailing Address - Country:US
Mailing Address - Phone:734-829-7188
Mailing Address - Fax:734-337-3340
Practice Address - Street 1:5900 COTTONWOOD DR
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-8203
Practice Address - Country:US
Practice Address - Phone:734-829-7188
Practice Address - Fax:734-337-3340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty