Provider Demographics
NPI:1508408865
Name:SPEECH REFINERY LLC
Entity Type:Organization
Organization Name:SPEECH REFINERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND SPEECH LANGUAGE PATHOLO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:617-842-8511
Mailing Address - Street 1:471 ARSENAL ST APT G
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-5016
Mailing Address - Country:US
Mailing Address - Phone:617-842-8511
Mailing Address - Fax:
Practice Address - Street 1:45 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-2402
Practice Address - Country:US
Practice Address - Phone:617-528-0625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty