Provider Demographics
NPI:1538517560
Name:THE SPEECH TREE
Entity Type:Organization
Organization Name:THE SPEECH TREE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:732-617-1500
Mailing Address - Street 1:23 KILMER DR
Mailing Address - Street 2:BUILDING 1, SUITES C AND D
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1563
Mailing Address - Country:US
Mailing Address - Phone:732-617-1500
Mailing Address - Fax:732-617-1600
Practice Address - Street 1:23 KILMER DR
Practice Address - Street 2:BUILDING 1, SUITES C AND D
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1563
Practice Address - Country:US
Practice Address - Phone:732-617-1500
Practice Address - Fax:732-617-1600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00597100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty