Provider Demographics
NPI:1518319748
Name:PROFESSIONAL SPEECH SERVICES LLC
Entity Type:Organization
Organization Name:PROFESSIONAL SPEECH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YEHUDIS
Authorized Official - Middle Name:
Authorized Official - Last Name:JUTCOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:908-907-0050
Mailing Address - Street 1:1414 TOWERS ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5447
Mailing Address - Country:US
Mailing Address - Phone:908-907-0050
Mailing Address - Fax:
Practice Address - Street 1:1414 TOWERS ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5447
Practice Address - Country:US
Practice Address - Phone:908-907-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty