Provider Demographics
NPI:1508498460
Name:GROWING TOGETHER: PEDIATRIC FEEDING AND SPEECH THERAPY, LLC
Entity Type:Organization
Organization Name:GROWING TOGETHER: PEDIATRIC FEEDING AND SPEECH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:617-329-9694
Mailing Address - Street 1:12 INDIAN BROOK LN
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-2611
Mailing Address - Country:US
Mailing Address - Phone:617-329-9694
Mailing Address - Fax:
Practice Address - Street 1:12 INDIAN BROOK LN
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2611
Practice Address - Country:US
Practice Address - Phone:617-329-9694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-09
Last Update Date:2020-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health